|
THYROIDECTOMY
|
Facility
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 60240
|
| Hospital Charge Code |
40109229
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,043.00 |
| Max. Negotiated Rate |
$7,320.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: 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 |
$1,043.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,158.89
|
| 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
|
|
|
THYROIDECTOMY - ISTHMUSECTOMY
|
Facility
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 60210
|
| Hospital Charge Code |
40019582
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$805.38 |
| Max. Negotiated Rate |
$7,320.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: 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 |
$805.38
|
| 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 |
$894.87
|
| 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
|
|
|
THYROIDECTOMY PARTIAL
|
Facility
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 60210
|
| Hospital Charge Code |
40109230
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$805.38 |
| Max. Negotiated Rate |
$7,320.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: 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 |
$805.38
|
| 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 |
$894.87
|
| 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
|
|
|
THYROIDECTOMY PARTIAL
|
Facility
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 60210
|
| Hospital Charge Code |
40013236
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$805.38 |
| Max. Negotiated Rate |
$7,320.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: 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 |
$805.38
|
| 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 |
$894.87
|
| 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
|
|
|
THYROIDECTOMY TOTAL
|
Facility
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 60240
|
| Hospital Charge Code |
40011065
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,043.00 |
| Max. Negotiated Rate |
$7,320.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: 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 |
$1,043.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,158.89
|
| 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
|
|
|
Thyroidectomy, total or complete
|
Facility
OP
|
$6,672.53
|
|
|
Service Code
|
CPT 60240
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,043.00 |
| Max. Negotiated Rate |
$6,672.53 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: 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 |
$1,043.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,158.89
|
| 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
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC
|
Facility
IP
|
$28,576.93
|
|
|
Service Code
|
MS-DRG 626
|
| Min. Negotiated Rate |
$12,793.00 |
| Max. Negotiated Rate |
$28,576.93 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$21,998.07
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$28,016.60
|
| Rate for Payer: Aetna Government |
$28,016.60
|
| Rate for Payer: Brighton Health Commercial |
$21,632.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$28,576.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$25,763.62
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$21,261.25
|
| Rate for Payer: Elderplan Medicare Advantage |
$26,615.77
|
| Rate for Payer: EmblemHealth Commercial |
$12,793.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$28,016.60
|
| Rate for Payer: Group Health Inc Commercial |
$28,016.60
|
| Rate for Payer: Group Health Inc Medicare |
$28,016.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$28,016.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13,027.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$28,016.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$28,016.60
|
| Rate for Payer: Wellcare Medicare |
$26,615.77
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC
|
Facility
IP
|
$50,446.20
|
|
|
Service Code
|
MS-DRG 625
|
| Min. Negotiated Rate |
$22,244.33 |
| Max. Negotiated Rate |
$50,446.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$43,073.09
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$47,837.26
|
| Rate for Payer: Aetna Government |
$47,837.26
|
| Rate for Payer: Brighton Health Commercial |
$42,357.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$48,794.01
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$50,446.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$41,630.37
|
| Rate for Payer: Elderplan Medicare Advantage |
$45,445.40
|
| Rate for Payer: EmblemHealth Commercial |
$25,049.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$47,837.26
|
| Rate for Payer: Group Health Inc Commercial |
$47,837.26
|
| Rate for Payer: Group Health Inc Medicare |
$47,837.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$47,837.26
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22,244.33
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$47,837.26
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$47,837.26
|
| Rate for Payer: Wellcare Medicare |
$45,445.40
|
|
|
THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$24,957.29
|
|
|
Service Code
|
MS-DRG 627
|
| Min. Negotiated Rate |
$10,598.70 |
| Max. Negotiated Rate |
$24,957.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$18,224.82
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$24,467.93
|
| Rate for Payer: Aetna Government |
$24,467.93
|
| Rate for Payer: Brighton Health Commercial |
$17,922.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$24,957.29
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$21,344.48
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17,614.38
|
| Rate for Payer: Elderplan Medicare Advantage |
$23,244.53
|
| Rate for Payer: EmblemHealth Commercial |
$10,598.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$24,467.93
|
| Rate for Payer: Group Health Inc Commercial |
$24,467.93
|
| Rate for Payer: Group Health Inc Medicare |
$24,467.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$24,467.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11,377.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$24,467.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$24,467.93
|
| Rate for Payer: Wellcare Medicare |
$23,244.53
|
|
|
THYROID PEROXIDASE (TPO) AB
|
Facility
OP
|
$36.38
|
|
|
Service Code
|
HCPCS 86376
|
| Hospital Charge Code |
40729344
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.64 |
| Max. Negotiated Rate |
$23.13 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$20.01
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$14.55
|
| Rate for Payer: Aetna Government |
$14.55
|
| Rate for Payer: Cash Price |
$14.55
|
| Rate for Payer: Cash Price |
$14.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$14.55
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$23.13
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$19.57
|
| Rate for Payer: Elderplan Medicare Advantage |
$14.55
|
| Rate for Payer: EmblemHealth Commercial |
$14.55
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$13.10
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$12.95
|
| Rate for Payer: Fidelis Medicare Advantage |
$14.55
|
| Rate for Payer: Fidelis Qualified Health Plan |
$12.95
|
| Rate for Payer: Group Health Inc Commercial |
$14.55
|
| Rate for Payer: Group Health Inc Medicare |
$14.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.55
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$14.55
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14.55
|
| Rate for Payer: Healthfirst QHP |
$14.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$14.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$14.55
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$11.64
|
| Rate for Payer: Wellcare Medicare |
$13.10
|
|
|
THYROTROPIN 1.1 MG INJ
|
Facility
OP
|
$1,089.00
|
|
|
Service Code
|
HCPCS J3240
|
| Hospital Charge Code |
41652973
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$544.50 |
| Max. Negotiated Rate |
$2,143.71 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$598.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,021.17
|
| Rate for Payer: Aetna Government |
$2,021.17
|
| Rate for Payer: Cash Price |
$2,021.17
|
| Rate for Payer: Cash Price |
$2,021.17
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,021.17
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$544.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$626.18
|
| Rate for Payer: Elderplan Medicare Advantage |
$2,021.17
|
| Rate for Payer: EmblemHealth Commercial |
$2,021.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,021.17
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,021.17
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,122.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,021.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,122.23
|
| Rate for Payer: Group Health Inc Commercial |
$2,021.17
|
| Rate for Payer: Group Health Inc Medicare |
$2,021.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$544.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$544.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,001.48
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,717.99
|
| Rate for Payer: Healthfirst QHP |
$2,021.17
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,021.17
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,143.71
|
| Rate for Payer: SOMOS Essential |
$2,143.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$707.85
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,616.94
|
| Rate for Payer: Wellcare Medicare |
$1,920.11
|
|
|
THYROTROPIN 1.1 MG INJ
|
Facility
IP
|
$1,089.00
|
|
|
Service Code
|
HCPCS J3240
|
| Hospital Charge Code |
41652973
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$544.50 |
| Max. Negotiated Rate |
$544.50 |
| Rate for Payer: Cash Price |
$2,021.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$544.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$544.50
|
|
|
THYROTROPIN 1.1 MG INJ
|
Facility
OP
|
$1,089.00
|
|
|
Service Code
|
HCPCS J3240
|
| Hospital Charge Code |
41642973
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$544.50 |
| Max. Negotiated Rate |
$2,143.71 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$598.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,021.17
|
| Rate for Payer: Aetna Government |
$2,021.17
|
| Rate for Payer: Cash Price |
$2,021.17
|
| Rate for Payer: Cash Price |
$2,021.17
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,021.17
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$544.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$626.18
|
| Rate for Payer: Elderplan Medicare Advantage |
$2,021.17
|
| Rate for Payer: EmblemHealth Commercial |
$2,021.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,021.17
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,021.17
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,122.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,021.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,122.23
|
| Rate for Payer: Group Health Inc Commercial |
$2,021.17
|
| Rate for Payer: Group Health Inc Medicare |
$2,021.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$544.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$544.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,001.48
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,717.99
|
| Rate for Payer: Healthfirst QHP |
$2,021.17
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,021.17
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,143.71
|
| Rate for Payer: SOMOS Essential |
$2,143.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$707.85
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,616.94
|
| Rate for Payer: Wellcare Medicare |
$1,920.11
|
|
|
THYROTROPIN 1.1 MG INJ
|
Facility
IP
|
$1,089.00
|
|
|
Service Code
|
HCPCS J3240
|
| Hospital Charge Code |
41642973
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$544.50 |
| Max. Negotiated Rate |
$544.50 |
| Rate for Payer: Cash Price |
$2,021.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$544.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$544.50
|
|
|
THYROTROPIN RECEPTOR AB SERUM
|
Facility
OP
|
$43.18
|
|
|
Service Code
|
HCPCS 83520
|
| Hospital Charge Code |
40609718
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.82 |
| Max. Negotiated Rate |
$23.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$23.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17.27
|
| Rate for Payer: Aetna Government |
$17.27
|
| Rate for Payer: Cash Price |
$17.27
|
| Rate for Payer: Cash Price |
$17.27
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$17.27
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.41
|
| Rate for Payer: Elderplan Medicare Advantage |
$17.27
|
| Rate for Payer: EmblemHealth Commercial |
$17.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$15.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$14.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$17.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.37
|
| Rate for Payer: Group Health Inc Commercial |
$17.27
|
| Rate for Payer: Group Health Inc Medicare |
$17.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17.27
|
| Rate for Payer: Healthfirst QHP |
$17.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17.27
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$13.82
|
| Rate for Payer: Wellcare Medicare |
$15.54
|
|
|
THYROXINE_BINDING_GLOBULIN
|
Facility
OP
|
$36.95
|
|
|
Service Code
|
HCPCS 84442
|
| Hospital Charge Code |
40609122
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.82 |
| Max. Negotiated Rate |
$23.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$20.32
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$14.78
|
| Rate for Payer: Aetna Government |
$14.78
|
| Rate for Payer: Cash Price |
$14.78
|
| Rate for Payer: Cash Price |
$14.78
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$14.78
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$23.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$19.90
|
| Rate for Payer: Elderplan Medicare Advantage |
$14.78
|
| Rate for Payer: EmblemHealth Commercial |
$14.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$13.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$14.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13.15
|
| Rate for Payer: Group Health Inc Commercial |
$14.78
|
| Rate for Payer: Group Health Inc Medicare |
$14.78
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$14.78
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14.78
|
| Rate for Payer: Healthfirst QHP |
$14.78
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$14.78
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$14.78
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$11.82
|
| Rate for Payer: Wellcare Medicare |
$13.30
|
|
|
THYROXINE (T4) FREE, DIRECT, S
|
Facility
OP
|
$22.55
|
|
|
Service Code
|
HCPCS 84439
|
| Hospital Charge Code |
40609121
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.22 |
| Max. Negotiated Rate |
$14.34 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$12.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.02
|
| Rate for Payer: Aetna Government |
$9.02
|
| Rate for Payer: Cash Price |
$9.02
|
| Rate for Payer: Cash Price |
$9.02
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.02
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$14.34
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12.13
|
| Rate for Payer: Elderplan Medicare Advantage |
$9.02
|
| Rate for Payer: EmblemHealth Commercial |
$9.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.12
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7.67
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.03
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.03
|
| Rate for Payer: Group Health Inc Commercial |
$9.02
|
| Rate for Payer: Group Health Inc Medicare |
$9.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.02
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.02
|
| Rate for Payer: Healthfirst QHP |
$9.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.02
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$7.22
|
| Rate for Payer: Wellcare Medicare |
$8.12
|
|
|
TI2.9MM LCKNG SCR,SELF-TAPPING6MM
|
Facility
OP
|
$320.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40209502
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.00 |
| Max. Negotiated Rate |
$336.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$176.00
|
| 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 |
$160.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$184.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$336.00
|
| Rate for Payer: Group Health Inc Commercial |
$160.00
|
| Rate for Payer: Group Health Inc Medicare |
$112.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$160.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$160.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$208.00
|
|
|
TI2.9MM LCKNG SCR,SELF-TAPPING6MM
|
Facility
IP
|
$320.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40209502
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$160.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$160.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$160.00
|
|
|
TI2.9MM LCKNGSCRW SELFTAP/12MM
|
Facility
IP
|
$1,600.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40209510
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$800.00 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$800.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$800.00
|
|
|
TI2.9MM LCKNGSCRW SELFTAP/12MM
|
Facility
OP
|
$1,600.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40209510
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$1,680.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$880.00
|
| 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 |
$800.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$920.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,680.00
|
| Rate for Payer: Group Health Inc Commercial |
$800.00
|
| Rate for Payer: Group Health Inc Medicare |
$560.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$800.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$800.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,040.00
|
|
|
TI2.9MM LCKNGSCRW,SELFTAPPING10MM
|
Facility
OP
|
$320.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40209507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.00 |
| Max. Negotiated Rate |
$336.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$176.00
|
| 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 |
$160.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$184.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$336.00
|
| Rate for Payer: Group Health Inc Commercial |
$160.00
|
| Rate for Payer: Group Health Inc Medicare |
$112.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$160.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$160.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$208.00
|
|
|
TI2.9MM LCKNGSCRW,SELFTAPPING10MM
|
Facility
IP
|
$320.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40209507
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$160.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$160.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$160.00
|
|
|
TI2.9MM LCKNGSCRW SELFTAPPING12MM
|
Facility
OP
|
$320.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40209509
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.00 |
| Max. Negotiated Rate |
$336.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$176.00
|
| 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 |
$160.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$184.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$336.00
|
| Rate for Payer: Group Health Inc Commercial |
$160.00
|
| Rate for Payer: Group Health Inc Medicare |
$112.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$160.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$160.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$208.00
|
|
|
TI2.9MM LCKNGSCRW SELFTAPPING12MM
|
Facility
IP
|
$320.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40209509
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$160.00 |
| Max. Negotiated Rate |
$160.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$160.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$160.00
|
|
