|
BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC
|
Facility
IP
|
$33,840.19
|
|
|
Service Code
|
MS-DRG 479
|
| Min. Negotiated Rate |
$15,427.15 |
| Max. Negotiated Rate |
$33,840.19 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$27,484.68
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$33,176.66
|
| Rate for Payer: Aetna Government |
$33,176.66
|
| Rate for Payer: Brighton Health Commercial |
$27,028.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$33,840.19
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$32,189.42
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$26,564.09
|
| Rate for Payer: Elderplan Medicare Advantage |
$31,517.83
|
| Rate for Payer: EmblemHealth Commercial |
$15,983.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$33,176.66
|
| Rate for Payer: Group Health Inc Commercial |
$33,176.66
|
| Rate for Payer: Group Health Inc Medicare |
$33,176.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$33,176.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15,427.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$33,176.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$33,176.66
|
| Rate for Payer: Wellcare Medicare |
$31,517.83
|
|
|
Biopsy, abdominal or retroperitoneal mass, percutaneous needle
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 49180
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$88.34 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,874.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$88.34
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$98.16
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
BIOPSY-AXILLARY LYMPH NODE
|
Facility
OP
|
$9,175.75
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
40010595
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$510.51 |
| Max. Negotiated Rate |
$4,587.88 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,407.98
|
| Rate for Payer: Aetna Government |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,407.98
|
| 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 |
$4,407.98
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$510.51
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,746.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,923.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,407.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,923.10
|
| Rate for Payer: Group Health Inc Commercial |
$4,407.98
|
| Rate for Payer: Group Health Inc Medicare |
$4,407.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,587.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,407.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$567.23
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,746.78
|
| Rate for Payer: Healthfirst QHP |
$4,407.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,407.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,407.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,526.38
|
| Rate for Payer: Wellcare Medicare |
$4,187.58
|
|
|
BIOPSY, BONE, OPEN, SUPERFICIAL
|
Facility
OP
|
$7,023.35
|
|
|
Service Code
|
HCPCS 20240
|
| Hospital Charge Code |
30307790
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$150.30 |
| Max. Negotiated Rate |
$3,511.68 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,285.96
|
| Rate for Payer: Aetna Government |
$3,285.96
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$3,285.96
|
| Rate for Payer: Cash Price |
$3,285.96
|
| Rate for Payer: Cash Price |
$3,285.96
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,285.96
|
| 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 |
$3,285.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$150.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,793.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,924.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,285.96
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,924.50
|
| 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 |
$3,511.68
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,285.96
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$167.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,793.07
|
| Rate for Payer: Healthfirst QHP |
$3,285.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,285.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,285.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,285.96
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,628.77
|
| Rate for Payer: Wellcare Medicare |
$3,121.66
|
|
|
Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur)
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 20225
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$137.53 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$137.53
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$152.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur)
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 20225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$137.53 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,874.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$137.53
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$152.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs)
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 20220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$93.56 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,874.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$93.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$103.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs)
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 20220
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$93.56 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$93.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$103.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
BIOPSY-BREAST,FROZEN SECTION
|
Facility
OP
|
$9,175.75
|
|
|
Service Code
|
HCPCS 19101
|
| Hospital Charge Code |
40010600
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$258.38 |
| Max. Negotiated Rate |
$4,587.88 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,407.98
|
| Rate for Payer: Aetna Government |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,407.98
|
| 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 |
$4,407.98
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$258.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,746.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,923.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,407.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,923.10
|
| Rate for Payer: Group Health Inc Commercial |
$4,407.98
|
| Rate for Payer: Group Health Inc Medicare |
$4,407.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,587.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,407.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$287.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,746.78
|
| Rate for Payer: Healthfirst QHP |
$4,407.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,407.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,407.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,526.38
|
| Rate for Payer: Wellcare Medicare |
$4,187.58
|
|
|
Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including stereotactic guidance (List separately in addition to code for primary procedure)
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 19082
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$72.75 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$72.75
|
| Rate for Payer: Aetna Government |
$72.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$87.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$97.76
|
|
|
Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including ultrasound guidance (List separately in addition to code for primary procedure)
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 19084
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$68.16 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$68.16
|
| Rate for Payer: Aetna Government |
$68.16
|
| 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: Fidelis CHP/HARP/Medicaid |
$82.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$92.17
|
|
|
Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including stereotactic guidance
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 19081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$173.87 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,874.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$173.87
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$193.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including ultrasound guidance
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 19083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$163.05 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,874.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$163.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$181.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
BIOPSY-CERVICAL LYMPH NODE
|
Facility
OP
|
$9,175.75
|
|
|
Service Code
|
HCPCS 38510
|
| Hospital Charge Code |
40010605
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$474.21 |
| Max. Negotiated Rate |
$4,587.88 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,407.98
|
| Rate for Payer: Aetna Government |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,407.98
|
| 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 |
$4,407.98
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$474.21
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,746.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,923.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,407.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,923.10
|
| Rate for Payer: Group Health Inc Commercial |
$4,407.98
|
| Rate for Payer: Group Health Inc Medicare |
$4,407.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,587.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,407.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$526.90
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,746.78
|
| Rate for Payer: Healthfirst QHP |
$4,407.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,407.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,407.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,526.38
|
| Rate for Payer: Wellcare Medicare |
$4,187.58
|
|
|
BIOPSY-CLAVICULAR LYMPH NODE
|
Facility
OP
|
$9,175.75
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
40031850
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$294.46 |
| Max. Negotiated Rate |
$4,587.88 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,407.98
|
| Rate for Payer: Aetna Government |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,407.98
|
| 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 |
$4,407.98
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$294.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,746.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,923.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,407.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,923.10
|
| Rate for Payer: Group Health Inc Commercial |
$4,407.98
|
| Rate for Payer: Group Health Inc Medicare |
$4,407.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,587.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,407.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$327.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,746.78
|
| Rate for Payer: Healthfirst QHP |
$4,407.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,407.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,407.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,526.38
|
| Rate for Payer: Wellcare Medicare |
$4,187.58
|
|
|
BIOPSY CRANIAL FRAMELESS
|
Facility
OP
|
$13,250.00
|
|
| Hospital Charge Code |
64905992
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,637.50 |
| Max. Negotiated Rate |
$10,600.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7,287.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,625.00
|
| Rate for Payer: Aetna Government |
$6,625.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$10,600.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9,010.00
|
| Rate for Payer: Group Health Inc Commercial |
$6,625.00
|
| Rate for Payer: Group Health Inc Medicare |
$4,637.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6,625.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,625.00
|
|
|
BIOPSY-MUSCLE
|
Facility
OP
|
$4,157.25
|
|
|
Service Code
|
HCPCS 20200
|
| Hospital Charge Code |
40010610
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$110.02 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$110.02
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,078.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$122.24
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
BIOPSY-NECK
|
Facility
OP
|
$4,157.25
|
|
|
Service Code
|
HCPCS 21550
|
| Hospital Charge Code |
40010615
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$172.60 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$172.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,078.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$191.78
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
BIOPSY OF ANORECTAL WALL, ANAL AP
|
Facility
OP
|
$7,099.93
|
|
|
Service Code
|
HCPCS 45100
|
| Hospital Charge Code |
40010701
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$341.13 |
| Max. Negotiated Rate |
$3,549.96 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,246.99
|
| Rate for Payer: Aetna Government |
$3,246.99
|
| Rate for Payer: Cash Price |
$3,246.99
|
| Rate for Payer: Cash Price |
$3,246.99
|
| Rate for Payer: Cash Price |
$3,246.99
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,246.99
|
| 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 |
$3,246.99
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$341.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,759.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,889.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,246.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,889.82
|
| Rate for Payer: Group Health Inc Commercial |
$3,246.99
|
| Rate for Payer: Group Health Inc Medicare |
$3,246.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,549.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,246.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$379.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,759.94
|
| Rate for Payer: Healthfirst QHP |
$3,246.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,246.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,246.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,597.59
|
| Rate for Payer: Wellcare Medicare |
$3,084.64
|
|
|
BIOPSY OF BONE SUPERFICIAL
|
Facility
OP
|
$4,157.25
|
|
|
Service Code
|
HCPCS 20220
|
| Hospital Charge Code |
42500186
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$93.56 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,874.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$93.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,078.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$103.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
Biopsy of breast; percutaneous, needle core, not using imaging guidance (separate procedure)
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 19100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$79.75 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,874.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$79.75
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$88.61
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
BIOPSY OF CERVIX
|
Facility
OP
|
$819.95
|
|
|
Service Code
|
HCPCS 57454
|
| Hospital Charge Code |
30107813
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$147.64 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$370.99
|
| Rate for Payer: Aetna Government |
$370.99
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$370.99
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$370.99
|
| Rate for Payer: Cash Price |
$370.99
|
| Rate for Payer: Cash Price |
$370.99
|
| Rate for Payer: Cash Price |
$370.99
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$370.99
|
| 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 |
$370.99
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$147.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$315.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$330.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$370.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$330.18
|
| 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 |
$409.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$370.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$370.99
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$370.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$370.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$370.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$296.79
|
| Rate for Payer: Wellcare Medicare |
$352.44
|
|
|
BIOPSY OF CERVIX
|
Facility
OP
|
$819.95
|
|
|
Service Code
|
HCPCS 57454
|
| Hospital Charge Code |
30300091
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$147.64 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$370.99
|
| Rate for Payer: Aetna Government |
$370.99
|
| Rate for Payer: Cash Price |
$370.99
|
| Rate for Payer: Cash Price |
$370.99
|
| Rate for Payer: Cash Price |
$370.99
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$370.99
|
| 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 |
$370.99
|
| Rate for Payer: EmblemHealth Commercial |
$745.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$147.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$315.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$330.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$370.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$330.18
|
| Rate for Payer: Group Health Inc Commercial |
$370.99
|
| Rate for Payer: Group Health Inc Medicare |
$370.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$409.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$370.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$164.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$315.34
|
| Rate for Payer: Healthfirst QHP |
$370.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$370.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$370.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$296.79
|
| Rate for Payer: Wellcare Medicare |
$352.44
|
|
|
BIOPSY OF CERVIX W/SCOPE
|
Facility
OP
|
$814.00
|
|
|
Service Code
|
HCPCS 57455
|
| Hospital Charge Code |
30303057
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$120.28 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$370.99
|
| Rate for Payer: Aetna Government |
$370.99
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$370.99
|
| Rate for Payer: Cash Price |
$370.99
|
| Rate for Payer: Cash Price |
$370.99
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$370.99
|
| 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 |
$370.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$120.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$315.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$330.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$370.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$330.18
|
| 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 |
$407.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$370.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$133.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$315.34
|
| Rate for Payer: Healthfirst QHP |
$370.99
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$370.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$370.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$370.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$296.79
|
| Rate for Payer: Wellcare Medicare |
$352.44
|
|
|
BIOPSY OF EXTERNAL EAR
|
Facility
OP
|
$395.39
|
|
|
Service Code
|
HCPCS 69100
|
| Hospital Charge Code |
30300111
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$50.87 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$282.47
|
| Rate for Payer: Aetna Government |
$282.47
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$282.47
|
| Rate for Payer: Cash Price |
$282.47
|
| Rate for Payer: Cash Price |
$282.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$282.47
|
| 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 |
$282.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$50.87
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$240.10
|
| Rate for Payer: Fidelis Essential Plan QHP |
$251.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$282.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$251.40
|
| 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 |
$197.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$282.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$56.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$240.10
|
| Rate for Payer: Healthfirst QHP |
$282.47
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$282.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$282.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$282.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$225.98
|
| Rate for Payer: Wellcare Medicare |
$268.35
|
|
