|
THORACOSTOMY W/OPEN FLAP DRAINAGE
|
Facility
OP
|
$2,085.73
|
|
|
Service Code
|
HCPCS 32036
|
| Hospital Charge Code |
40019716
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$730.01 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,147.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$845.34
|
| Rate for Payer: Aetna Government |
$845.34
|
| 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 |
$906.17
|
| Rate for Payer: Group Health Inc Commercial |
$1,042.86
|
| Rate for Payer: Group Health Inc Medicare |
$730.01
|
| 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 |
$1,006.86
|
|
|
THORACOSTOMY W/OPEN FLAP DRAINAGE
|
Facility
OP
|
$2,085.73
|
|
|
Service Code
|
HCPCS 32036
|
| Hospital Charge Code |
30302456
|
|
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
|
|
|
THORACOTOMY
|
Facility
OP
|
$2,096.03
|
|
|
Service Code
|
HCPCS 32160
|
| Hospital Charge Code |
40042135
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$733.61 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,152.82
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$858.42
|
| Rate for Payer: Aetna Government |
$858.42
|
| 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 |
$910.84
|
| Rate for Payer: Group Health Inc Commercial |
$1,048.02
|
| Rate for Payer: Group Health Inc Medicare |
$733.61
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,048.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,048.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,012.05
|
|
|
THORACOTOMY, PNEUMONECTOMY
|
Facility
OP
|
$5,126.42
|
|
|
Service Code
|
HCPCS 32440
|
| Hospital Charge Code |
40042145
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,819.53
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,711.54
|
| Rate for Payer: Aetna Government |
$1,711.54
|
| 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: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,792.81
|
| Rate for Payer: Group Health Inc Commercial |
$2,563.21
|
| Rate for Payer: Group Health Inc Medicare |
$1,794.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,563.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,563.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,992.01
|
|
|
THORACOTOMY TRAY
|
Facility
OP
|
$65.21
|
|
| Hospital Charge Code |
40206020
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.82 |
| Max. Negotiated Rate |
$52.17 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$35.87
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$32.60
|
| Rate for Payer: Aetna Government |
$32.60
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$52.17
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$44.34
|
| Rate for Payer: Group Health Inc Commercial |
$32.60
|
| Rate for Payer: Group Health Inc Medicare |
$22.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$32.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$32.60
|
|
|
THORACOTOMY WITH EXPLORATION
|
Facility
OP
|
$5,240.07
|
|
|
Service Code
|
HCPCS 32160
|
| Hospital Charge Code |
30106521
|
|
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 |
$858.42
|
| Rate for Payer: Aetna Government |
$858.42
|
| 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 |
$910.84
|
| 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 |
$2,620.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,620.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
|
|
THORA DRAIN
|
Facility
OP
|
$124.74
|
|
| Hospital Charge Code |
40206001
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$43.66 |
| Max. Negotiated Rate |
$99.79 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$68.61
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$62.37
|
| Rate for Payer: Aetna Government |
$62.37
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$99.79
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$84.82
|
| Rate for Payer: Group Health Inc Commercial |
$62.37
|
| Rate for Payer: Group Health Inc Medicare |
$43.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$62.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$62.37
|
|
|
THORANCENTESIS W/TUBE INSERTION
|
Facility
OP
|
$1,909.65
|
|
|
Service Code
|
HCPCS 32555
|
| Hospital Charge Code |
40019459
|
|
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
|
|
|
THOROCOSCOPY CONTROL TRAUMA BLEED
|
Facility
OP
|
$2,005.43
|
|
|
Service Code
|
HCPCS 32650
|
| Hospital Charge Code |
40019632
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$701.90 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,102.99
|
| 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 |
$1,002.72
|
| Rate for Payer: Group Health Inc Medicare |
$701.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,002.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,002.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$845.44
|
|
|
THOROCOSCOPY REMOVAL BLOOD CLOT/F
|
Facility
OP
|
$2,168.55
|
|
|
Service Code
|
HCPCS 32658
|
| Hospital Charge Code |
40019633
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$758.99 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,192.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$780.69
|
| Rate for Payer: Aetna Government |
$780.69
|
| 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 |
$819.48
|
| Rate for Payer: Group Health Inc Commercial |
$1,084.28
|
| Rate for Payer: Group Health Inc Medicare |
$758.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,084.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,084.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$910.53
|
|
|
THOROCOSCOPY REPAIR STERNUM
|
Facility
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 21743
|
| Hospital Charge Code |
40029634
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$4,145.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| 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 Essential Plan Aliesa |
$3,181.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,331.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,743.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,331.40
|
| Rate for Payer: Group Health Inc Commercial |
$3,743.15
|
| Rate for Payer: Group Health Inc Medicare |
$3,743.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,145.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,743.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: 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
|
|
|
THOROCOTOMY LUNG BIOPSY
|
Facility
OP
|
$3,423.26
|
|
|
Service Code
|
HCPCS 32100
|
| Hospital Charge Code |
40043206
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$883.48 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,882.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$883.48
|
| Rate for Payer: Aetna Government |
$883.48
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$924.08
|
| 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 |
$1,026.76
|
|
|
THOROCOTOMY REM. BULLAE
|
Facility
OP
|
$3,423.26
|
|
|
Service Code
|
HCPCS 32141
|
| Hospital Charge Code |
40043205
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,198.14 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,882.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,667.05
|
| Rate for Payer: Aetna Government |
$1,667.05
|
| 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 |
$1,741.08
|
| 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 |
$1,934.53
|
|
|
THOROCOTOMY REM. CYST
|
Facility
OP
|
$3,423.26
|
|
|
Service Code
|
HCPCS 32140
|
| Hospital Charge Code |
40043204
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,090.94 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,882.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,090.94
|
| Rate for Payer: Aetna Government |
$1,090.94
|
| 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 |
$1,134.04
|
| 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 |
$1,260.05
|
|
|
THREADED 32 GUIDE PIN
|
Facility
OP
|
$337.50
|
|
| Hospital Charge Code |
64906021
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$118.12 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$185.62
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$168.75
|
| Rate for Payer: Aetna Government |
$168.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$270.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$229.50
|
| Rate for Payer: Group Health Inc Commercial |
$168.75
|
| Rate for Payer: Group Health Inc Medicare |
$118.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$168.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$168.75
|
|
|
THREADED GUIDE PIN 3.2MM
|
Facility
IP
|
$368.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006163
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$184.00 |
| Max. Negotiated Rate |
$184.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$184.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$184.00
|
|
|
THREADED GUIDE PIN 3.2MM
|
Facility
OP
|
$368.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40006163
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$128.80 |
| Max. Negotiated Rate |
$386.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$202.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
| Rate for Payer: Aetna Government |
$134.20
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$184.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$211.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$386.40
|
| Rate for Payer: Group Health Inc Commercial |
$184.00
|
| Rate for Payer: Group Health Inc Medicare |
$128.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$184.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$184.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$239.20
|
|
|
THROAT SCREEN
|
Facility
OP
|
$21.55
|
|
|
Service Code
|
HCPCS 87070
|
| Hospital Charge Code |
40614060
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$13.70 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.62
|
| Rate for Payer: Aetna Government |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| Rate for Payer: Cash Price |
$8.62
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8.62
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.70
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.59
|
| Rate for Payer: Elderplan Medicare Advantage |
$8.62
|
| Rate for Payer: EmblemHealth Commercial |
$8.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.67
|
| Rate for Payer: Group Health Inc Commercial |
$8.62
|
| Rate for Payer: Group Health Inc Medicare |
$8.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.62
|
| Rate for Payer: Healthfirst QHP |
$8.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.62
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6.90
|
| Rate for Payer: Wellcare Medicare |
$7.76
|
|
|
THROAT SURGERY PROCEDURE
|
Facility
OP
|
$616.78
|
|
|
Service Code
|
HCPCS 42999
|
| Hospital Charge Code |
40109202
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$225.98 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$282.47
|
| Rate for Payer: Aetna Government |
$282.47
|
| 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: EmblemHealth Commercial |
$1,505.00
|
| 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 |
$282.47
|
| Rate for Payer: Group Health Inc Medicare |
$282.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$308.39
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$282.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$240.10
|
| Rate for Payer: Healthfirst QHP |
$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
|
|
|
THROMBECTOMY FEMORAL ARTERY
|
Facility
OP
|
$13,920.70
|
|
|
Service Code
|
HCPCS 34201
|
| Hospital Charge Code |
40033215
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,167.26 |
| Max. Negotiated Rate |
$6,960.35 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,354.94
|
| Rate for Payer: Aetna Government |
$6,354.94
|
| Rate for Payer: Cash Price |
$6,354.94
|
| Rate for Payer: Cash Price |
$6,354.94
|
| Rate for Payer: Cash Price |
$6,354.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,354.94
|
| 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 |
$6,354.94
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,167.26
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,401.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,655.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,354.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,655.90
|
| Rate for Payer: Group Health Inc Commercial |
$6,354.94
|
| Rate for Payer: Group Health Inc Medicare |
$6,354.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6,960.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,354.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,296.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,401.70
|
| Rate for Payer: Healthfirst QHP |
$6,354.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,354.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,354.94
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,083.95
|
| Rate for Payer: Wellcare Medicare |
$6,037.19
|
|
|
THROMBECTOMY/LYSIS DIALYS CIRC
|
Facility
OP
|
$15,004.15
|
|
|
Service Code
|
HCPCS 36904
|
| Hospital Charge Code |
40034518
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$342.00 |
| Max. Negotiated Rate |
$7,502.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,609.72
|
| Rate for Payer: Aetna Government |
$6,609.72
|
| Rate for Payer: Cash Price |
$6,609.72
|
| Rate for Payer: Cash Price |
$6,609.72
|
| Rate for Payer: Cash Price |
$6,609.72
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,609.72
|
| 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 |
$6,609.72
|
| Rate for Payer: EmblemHealth Commercial |
$6,609.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$397.01
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,618.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,882.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,609.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,882.65
|
| Rate for Payer: Group Health Inc Commercial |
$6,609.72
|
| Rate for Payer: Group Health Inc Medicare |
$6,609.72
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,502.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,609.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$441.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,618.26
|
| Rate for Payer: Healthfirst QHP |
$6,609.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,609.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,609.72
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,287.78
|
| Rate for Payer: Wellcare Medicare |
$6,279.23
|
|
|
THROMBECTOMY PERONEAL ARTERY
|
Facility
OP
|
$13,920.70
|
|
|
Service Code
|
HCPCS 34203
|
| Hospital Charge Code |
40033213
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,082.84 |
| Max. Negotiated Rate |
$6,960.35 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,354.94
|
| Rate for Payer: Aetna Government |
$6,354.94
|
| Rate for Payer: Cash Price |
$6,354.94
|
| Rate for Payer: Cash Price |
$6,354.94
|
| Rate for Payer: Cash Price |
$6,354.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,354.94
|
| 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 |
$6,354.94
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,082.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,401.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,655.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,354.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,655.90
|
| Rate for Payer: Group Health Inc Commercial |
$6,354.94
|
| Rate for Payer: Group Health Inc Medicare |
$6,354.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6,960.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,354.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,203.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,401.70
|
| Rate for Payer: Healthfirst QHP |
$6,354.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,354.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,354.94
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,083.95
|
| Rate for Payer: Wellcare Medicare |
$6,037.19
|
|
|
THROMBECTOMY POPLITEAL ARTERY
|
Facility
OP
|
$13,920.70
|
|
|
Service Code
|
HCPCS 34203
|
| Hospital Charge Code |
40033214
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,082.84 |
| Max. Negotiated Rate |
$6,960.35 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,354.94
|
| Rate for Payer: Aetna Government |
$6,354.94
|
| Rate for Payer: Cash Price |
$6,354.94
|
| Rate for Payer: Cash Price |
$6,354.94
|
| Rate for Payer: Cash Price |
$6,354.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,354.94
|
| 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 |
$6,354.94
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,082.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,401.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,655.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,354.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,655.90
|
| Rate for Payer: Group Health Inc Commercial |
$6,354.94
|
| Rate for Payer: Group Health Inc Medicare |
$6,354.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6,960.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,354.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,203.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,401.70
|
| Rate for Payer: Healthfirst QHP |
$6,354.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,354.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,354.94
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,083.95
|
| Rate for Payer: Wellcare Medicare |
$6,037.19
|
|
|
THROMBECTOMY VENA CAVA, ILIAC
|
Facility
OP
|
$4,111.23
|
|
|
Service Code
|
HCPCS 34401
|
| Hospital Charge Code |
40039867
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,438.93 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,261.18
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,633.93
|
| Rate for Payer: Aetna Government |
$1,633.93
|
| 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 |
$1,678.13
|
| Rate for Payer: Group Health Inc Commercial |
$2,055.62
|
| Rate for Payer: Group Health Inc Medicare |
$1,438.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,055.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,055.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,864.59
|
|
|
THROMBIN CLOTTING TIME
|
Facility
OP
|
$14.43
|
|
|
Service Code
|
HCPCS 85670
|
| Hospital Charge Code |
40628376
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$9.18 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.94
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.77
|
| Rate for Payer: Aetna Government |
$5.77
|
| Rate for Payer: Cash Price |
$5.77
|
| Rate for Payer: Cash Price |
$5.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.77
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$9.18
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.77
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.77
|
| Rate for Payer: EmblemHealth Commercial |
$5.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$5.19
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.90
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5.14
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5.14
|
| Rate for Payer: Group Health Inc Commercial |
$5.77
|
| Rate for Payer: Group Health Inc Medicare |
$5.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.77
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.77
|
| Rate for Payer: Healthfirst QHP |
$5.77
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.77
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.77
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.62
|
| Rate for Payer: Wellcare Medicare |
$5.19
|
|
