|
THIOTHIXENE 1 MG CAP
|
Facility
OP
|
$0.13
|
|
| Hospital Charge Code |
41654116
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.10 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.07
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.07
|
| Rate for Payer: Aetna Government |
$0.07
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.10
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.09
|
| Rate for Payer: Group Health Inc Commercial |
$0.07
|
| Rate for Payer: Group Health Inc Medicare |
$0.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.08
|
|
|
THIOTHIXENE 2 MG CAP
|
Facility
OP
|
$1.00
|
|
| Hospital Charge Code |
41650952
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$0.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.50
|
| Rate for Payer: Aetna Government |
$0.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.68
|
| Rate for Payer: Group Health Inc Commercial |
$0.50
|
| Rate for Payer: Group Health Inc Medicare |
$0.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.65
|
|
|
THIOTHIXENE 2 MG CAP
|
Facility
OP
|
$1.00
|
|
| Hospital Charge Code |
41640952
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$0.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.50
|
| Rate for Payer: Aetna Government |
$0.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.68
|
| Rate for Payer: Group Health Inc Commercial |
$0.50
|
| Rate for Payer: Group Health Inc Medicare |
$0.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.65
|
|
|
THIOTHIXENE 5 MG CAP
|
Facility
OP
|
$1.00
|
|
| Hospital Charge Code |
41650953
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$0.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.50
|
| Rate for Payer: Aetna Government |
$0.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.68
|
| Rate for Payer: Group Health Inc Commercial |
$0.50
|
| Rate for Payer: Group Health Inc Medicare |
$0.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.65
|
|
|
THIOTHIXENE 5 MG CAP
|
Facility
OP
|
$1.00
|
|
| Hospital Charge Code |
41640953
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$0.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.50
|
| Rate for Payer: Aetna Government |
$0.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.68
|
| Rate for Payer: Group Health Inc Commercial |
$0.50
|
| Rate for Payer: Group Health Inc Medicare |
$0.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.65
|
|
|
THOMPSON HIP PROSTHESIS
|
Facility
OP
|
$523.77
|
|
| Hospital Charge Code |
40202160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$183.32 |
| Max. Negotiated Rate |
$419.02 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$288.07
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$261.88
|
| Rate for Payer: Aetna Government |
$261.88
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$419.02
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$356.16
|
| Rate for Payer: Group Health Inc Commercial |
$261.88
|
| Rate for Payer: Group Health Inc Medicare |
$183.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$261.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$261.88
|
|
|
THORACENTESIS
|
Facility
OP
|
$1,909.65
|
|
|
Service Code
|
HCPCS 32554
|
| Hospital Charge Code |
30102467
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$94.13 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$726.47
|
| Rate for Payer: Aetna Government |
$726.47
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$726.47
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$726.47
|
| Rate for Payer: Cash Price |
$726.47
|
| Rate for Payer: Cash Price |
$726.47
|
| Rate for Payer: Cash Price |
$726.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$726.47
|
| 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 |
$726.47
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$94.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$617.50
|
| Rate for Payer: Fidelis Essential Plan QHP |
$646.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$726.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$646.56
|
| 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 |
$954.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$726.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$726.47
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$726.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$726.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$726.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$581.18
|
| Rate for Payer: Wellcare Medicare |
$690.15
|
|
|
THORACENTESIS FOR ASPIRATION
|
Facility
OP
|
$1,909.65
|
|
|
Service Code
|
HCPCS 32554
|
| Hospital Charge Code |
30103036
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$94.13 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$726.47
|
| Rate for Payer: Aetna Government |
$726.47
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$726.47
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$726.47
|
| Rate for Payer: Cash Price |
$726.47
|
| Rate for Payer: Cash Price |
$726.47
|
| Rate for Payer: Cash Price |
$726.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$726.47
|
| 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 |
$726.47
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$94.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$617.50
|
| Rate for Payer: Fidelis Essential Plan QHP |
$646.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$726.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$646.56
|
| 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 |
$954.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$726.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$726.47
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$726.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$726.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$726.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$581.18
|
| Rate for Payer: Wellcare Medicare |
$690.15
|
|
|
THORACENTESIS FOR ASPIRATION
|
Facility
OP
|
$1,909.65
|
|
|
Service Code
|
HCPCS 32554
|
| Hospital Charge Code |
40011335
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$94.13 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$726.47
|
| Rate for Payer: Aetna Government |
$726.47
|
| Rate for Payer: Cash Price |
$726.47
|
| Rate for Payer: Cash Price |
$726.47
|
| Rate for Payer: Cash Price |
$726.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$726.47
|
| 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 |
$726.47
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$94.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$617.50
|
| Rate for Payer: Fidelis Essential Plan QHP |
$646.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$726.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$646.56
|
| Rate for Payer: Group Health Inc Commercial |
$726.47
|
| Rate for Payer: Group Health Inc Medicare |
$726.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$954.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$726.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$104.59
|
| Rate for Payer: Healthfirst Medicare Advantage |
$617.50
|
| Rate for Payer: Healthfirst QHP |
$726.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$726.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$726.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$581.18
|
| Rate for Payer: Wellcare Medicare |
$690.15
|
|
|
THORACENTESIS, NEEDLE/CATH W/O IM
|
Facility
OP
|
$1,909.65
|
|
|
Service Code
|
HCPCS 32554
|
| Hospital Charge Code |
30105761
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$94.13 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$726.47
|
| Rate for Payer: Aetna Government |
$726.47
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$726.47
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$726.47
|
| Rate for Payer: Cash Price |
$726.47
|
| Rate for Payer: Cash Price |
$726.47
|
| Rate for Payer: Cash Price |
$726.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$726.47
|
| 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 |
$726.47
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$94.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$617.50
|
| Rate for Payer: Fidelis Essential Plan QHP |
$646.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$726.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$646.56
|
| 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 |
$954.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$726.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$726.47
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$726.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$726.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$726.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$581.18
|
| Rate for Payer: Wellcare Medicare |
$690.15
|
|
|
Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 32555
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$114.53 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$726.47
|
| Rate for Payer: Aetna Government |
$726.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$726.47
|
| 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 |
$726.47
|
| Rate for Payer: EmblemHealth Commercial |
$726.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$114.53
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$617.50
|
| Rate for Payer: Fidelis Essential Plan QHP |
$646.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$726.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$646.56
|
| Rate for Payer: Group Health Inc Commercial |
$726.47
|
| Rate for Payer: Group Health Inc Medicare |
$726.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$726.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$127.26
|
| Rate for Payer: Healthfirst Medicare Advantage |
$617.50
|
| Rate for Payer: Healthfirst QHP |
$726.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$726.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$726.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$581.18
|
| Rate for Payer: Wellcare Medicare |
$690.15
|
|
|
Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 32555
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$114.53 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$726.47
|
| Rate for Payer: Aetna Government |
$726.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$726.47
|
| 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 |
$726.47
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$114.53
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$617.50
|
| Rate for Payer: Fidelis Essential Plan QHP |
$646.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$726.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$646.56
|
| Rate for Payer: Group Health Inc Commercial |
$726.47
|
| Rate for Payer: Group Health Inc Medicare |
$726.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$726.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$127.26
|
| Rate for Payer: Healthfirst Medicare Advantage |
$617.50
|
| Rate for Payer: Healthfirst QHP |
$726.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$726.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$726.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$581.18
|
| Rate for Payer: Wellcare Medicare |
$690.15
|
|
|
Thoracentesis Set
|
Facility
OP
|
$42.17
|
|
| Hospital Charge Code |
40206022
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.76 |
| Max. Negotiated Rate |
$33.74 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$23.19
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$21.08
|
| Rate for Payer: Aetna Government |
$21.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$33.74
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$28.68
|
| Rate for Payer: Group Health Inc Commercial |
$21.08
|
| Rate for Payer: Group Health Inc Medicare |
$14.76
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21.08
|
|
|
THORACENTESIS TRAY
|
Facility
OP
|
$45.36
|
|
| Hospital Charge Code |
40206010
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.88 |
| Max. Negotiated Rate |
$36.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$24.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$22.68
|
| Rate for Payer: Aetna Government |
$22.68
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$36.29
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$30.84
|
| Rate for Payer: Group Health Inc Commercial |
$22.68
|
| Rate for Payer: Group Health Inc Medicare |
$15.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.68
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$22.68
|
|
|
THORACENTESIS W/TUBE INSERT
|
Facility
OP
|
$1,909.65
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
40042095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$114.53 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$726.47
|
| Rate for Payer: Aetna Government |
$726.47
|
| Rate for Payer: Cash Price |
$726.47
|
| Rate for Payer: Cash Price |
$726.47
|
| Rate for Payer: Cash Price |
$726.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$726.47
|
| 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 |
$726.47
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$114.53
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$617.50
|
| Rate for Payer: Fidelis Essential Plan QHP |
$646.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$726.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$646.56
|
| Rate for Payer: Group Health Inc Commercial |
$726.47
|
| Rate for Payer: Group Health Inc Medicare |
$726.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$954.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$726.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$127.26
|
| Rate for Payer: Healthfirst Medicare Advantage |
$617.50
|
| Rate for Payer: Healthfirst QHP |
$726.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$726.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$726.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$581.18
|
| Rate for Payer: Wellcare Medicare |
$690.15
|
|
|
THORACIC EPID CTH PLACEMENT
|
Facility
OP
|
$2,459.50
|
|
|
Service Code
|
HCPCS 62324
|
| Hospital Charge Code |
30305018
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$94.27 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,054.06
|
| Rate for Payer: Aetna Government |
$1,054.06
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$1,054.06
|
| Rate for Payer: Cash Price |
$1,054.06
|
| Rate for Payer: Cash Price |
$1,054.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,054.06
|
| 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 |
$1,054.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$94.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$895.95
|
| Rate for Payer: Fidelis Essential Plan QHP |
$938.11
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,054.06
|
| Rate for Payer: Fidelis Qualified Health Plan |
$938.11
|
| 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 |
$1,229.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,054.06
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$104.74
|
| Rate for Payer: Healthfirst Medicare Advantage |
$895.95
|
| Rate for Payer: Healthfirst QHP |
$1,054.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,054.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,054.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,054.06
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$843.25
|
| Rate for Payer: Wellcare Medicare |
$1,001.36
|
|
|
THORACIC LAMINECTOMY
|
Facility
OP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 63003
|
| Hospital Charge Code |
40000545
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,497.79 |
| Max. Negotiated Rate |
$9,058.92 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,065.00
|
| 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 |
$1,497.79
|
| 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 |
$1,664.21
|
| 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
|
|
|
THORACOSCOPY DIAGNOSTIC
|
Facility
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 32601
|
| Hospital Charge Code |
40033216
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$351.07 |
| Max. Negotiated Rate |
$7,320.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| 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 CHP/HARP/Medicaid |
$351.07
|
| 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 Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$390.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Senior Whole Health 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
|
|
|
THORACOSCOPY EXC. BULLAE
|
Facility
OP
|
$3,423.26
|
|
|
Service Code
|
HCPCS 32655
|
| Hospital Charge Code |
40043218
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,045.03 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,882.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,045.03
|
| Rate for Payer: Aetna Government |
$1,045.03
|
| 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: Fidelis CHP/HARP/Medicaid |
$1,095.80
|
| Rate for Payer: Group Health Inc Commercial |
$1,711.63
|
| Rate for Payer: Group Health Inc Medicare |
$1,198.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,711.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,711.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,217.56
|
|
|
THORACOSCOPY LOBECTOMY
|
Facility
OP
|
$5,135.60
|
|
|
Service Code
|
HCPCS 32663
|
| Hospital Charge Code |
40043219
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,824.58
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,533.50
|
| Rate for Payer: Aetna Government |
$1,533.50
|
| 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: Fidelis CHP/HARP/Medicaid |
$1,599.77
|
| Rate for Payer: Group Health Inc Commercial |
$2,567.80
|
| Rate for Payer: Group Health Inc Medicare |
$1,797.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,567.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,567.80
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,777.52
|
|
|
THORACOSCOPY PARTIAL DECORT
|
Facility
OP
|
$5,135.60
|
|
|
Service Code
|
HCPCS 32651
|
| Hospital Charge Code |
40043221
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,198.64 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,824.58
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,198.64
|
| Rate for Payer: Aetna Government |
$1,198.64
|
| 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: Fidelis CHP/HARP/Medicaid |
$1,252.03
|
| Rate for Payer: Group Health Inc Commercial |
$2,567.80
|
| Rate for Payer: Group Health Inc Medicare |
$1,797.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,567.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,567.80
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,391.14
|
|
|
THORACOSCOPY PERICARDIAL WINDOW
|
Facility
OP
|
$3,423.26
|
|
|
Service Code
|
HCPCS 32659
|
| Hospital Charge Code |
40043217
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$799.01 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,882.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$799.01
|
| Rate for Payer: Aetna Government |
$799.01
|
| 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: Fidelis CHP/HARP/Medicaid |
$839.05
|
| Rate for Payer: Group Health Inc Commercial |
$1,711.63
|
| Rate for Payer: Group Health Inc Medicare |
$1,198.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,711.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,711.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$932.28
|
|
|
THORACOSCOPY PLEURODESIS
|
Facility
OP
|
$5,135.60
|
|
|
Service Code
|
HCPCS 32650
|
| Hospital Charge Code |
40043223
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$725.76 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,824.58
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$725.76
|
| Rate for Payer: Aetna Government |
$725.76
|
| 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: Fidelis CHP/HARP/Medicaid |
$760.90
|
| Rate for Payer: Group Health Inc Commercial |
$2,567.80
|
| Rate for Payer: Group Health Inc Medicare |
$1,797.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,567.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,567.80
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$845.44
|
|
|
THORACOSCOPY TOTAL DECORT
|
Facility
OP
|
$4,035.99
|
|
|
Service Code
|
HCPCS 32652
|
| Hospital Charge Code |
40043222
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,412.60 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,219.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,819.15
|
| Rate for Payer: Aetna Government |
$1,819.15
|
| 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: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,901.09
|
| Rate for Payer: Group Health Inc Commercial |
$2,018.00
|
| Rate for Payer: Group Health Inc Medicare |
$1,412.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,018.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,018.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,112.32
|
|
|
THORACOSTOMY W/OPEN FLAP DRAINAGE
|
Facility
OP
|
$2,085.73
|
|
|
Service Code
|
HCPCS 32036
|
| Hospital Charge Code |
30102456
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$694.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$845.34
|
| Rate for Payer: Aetna Government |
$845.34
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| 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 |
$525.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$906.17
|
| 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 |
$1,042.86
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,042.86
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
|
