|
REVISION OF FOOT BONES
|
Facility
|
OP
|
$36,044.28
|
|
|
Service Code
|
HCPCS 28737
|
| Hospital Charge Code |
40029426
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$27,033.21 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15,219.83
|
| Rate for Payer: Aetna Government |
$15,219.83
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$10,653.88
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$10,653.88
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10,653.88
|
| Rate for Payer: Brighton Health Commercial |
$27,033.21
|
| Rate for Payer: Cash Price |
$15,219.83
|
| Rate for Payer: Cash Price |
$15,219.83
|
| Rate for Payer: Cash Price |
$15,219.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15,219.83
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$15,219.83
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12,936.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13,545.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$15,219.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13,545.65
|
| Rate for Payer: Group Health Inc Commercial |
$15,219.83
|
| Rate for Payer: Group Health Inc Medicare |
$15,219.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,022.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15,219.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12,936.86
|
| Rate for Payer: Healthfirst QHP |
$15,219.83
|
| Rate for Payer: Humana Medicare |
$15,524.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15,219.83
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,219.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15,219.83
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12,175.86
|
| Rate for Payer: Wellcare Medicare |
$14,458.84
|
|
|
REVISION OF HIP OR KNEE REPLACEMENT WITH CC
|
Facility
|
IP
|
$76,551.35
|
|
|
Service Code
|
MSDRG 467
|
| Min. Negotiated Rate |
$25,888.28 |
| Max. Negotiated Rate |
$76,551.35 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$51,405.49
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$55,673.71
|
| Rate for Payer: Aetna Government |
$55,673.71
|
| Rate for Payer: Brighton Health Commercial |
$50,551.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$56,787.18
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$60,204.91
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$49,683.68
|
| Rate for Payer: Elderplan Medicare Advantage |
$52,890.02
|
| Rate for Payer: EmblemHealth Commercial |
$29,895.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$55,673.71
|
| Rate for Payer: Group Health Inc Commercial |
$55,673.71
|
| Rate for Payer: Group Health Inc Medicare |
$55,673.71
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$55,673.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$25,888.28
|
| Rate for Payer: Humana Medicare |
$76,551.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$55,673.71
|
| Rate for Payer: United Healthcare Commercial |
$69,332.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$55,673.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$55,673.71
|
| Rate for Payer: Wellcare Medicare |
$52,890.02
|
|
|
REVISION OF HIP OR KNEE REPLACEMENT WITH MCC
|
Facility
|
IP
|
$108,972.06
|
|
|
Service Code
|
MSDRG 466
|
| Min. Negotiated Rate |
$36,852.37 |
| Max. Negotiated Rate |
$108,972.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$76,476.42
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$79,252.41
|
| Rate for Payer: Aetna Government |
$79,252.41
|
| Rate for Payer: Brighton Health Commercial |
$75,205.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$80,837.46
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$89,567.40
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$73,914.86
|
| Rate for Payer: Elderplan Medicare Advantage |
$75,289.79
|
| Rate for Payer: EmblemHealth Commercial |
$44,475.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$79,252.41
|
| Rate for Payer: Group Health Inc Commercial |
$79,252.41
|
| Rate for Payer: Group Health Inc Medicare |
$79,252.41
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$79,252.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$36,852.37
|
| Rate for Payer: Humana Medicare |
$108,972.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$79,252.41
|
| Rate for Payer: United Healthcare Commercial |
$103,145.91
|
| Rate for Payer: United Healthcare Medicare Advantage |
$79,252.41
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$79,252.41
|
| Rate for Payer: Wellcare Medicare |
$75,289.79
|
|
|
REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$60,978.80
|
|
|
Service Code
|
MSDRG 468
|
| Min. Negotiated Rate |
$20,621.92 |
| Max. Negotiated Rate |
$60,978.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$39,363.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$44,348.22
|
| Rate for Payer: Aetna Government |
$44,348.22
|
| Rate for Payer: Brighton Health Commercial |
$38,709.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$45,235.18
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$46,101.32
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$38,044.79
|
| Rate for Payer: Elderplan Medicare Advantage |
$42,130.81
|
| Rate for Payer: EmblemHealth Commercial |
$22,891.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$44,348.22
|
| Rate for Payer: Group Health Inc Commercial |
$44,348.22
|
| Rate for Payer: Group Health Inc Medicare |
$44,348.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$44,348.22
|
| Rate for Payer: Healthfirst Medicare Advantage |
$20,621.92
|
| Rate for Payer: Humana Medicare |
$60,978.80
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$44,348.22
|
| Rate for Payer: United Healthcare Commercial |
$53,090.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$44,348.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$44,348.22
|
| Rate for Payer: Wellcare Medicare |
$42,130.81
|
|
|
REVISION OF LOWER LEG TENDON
|
Facility
|
IP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 27685
|
| Hospital Charge Code |
40014265
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,743.15
|
|
|
REVISION OF LOWER LEG TENDON
|
Facility
|
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 27685
|
| Hospital Charge Code |
40014265
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$6,218.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,743.15
|
| Rate for Payer: Aetna Government |
$3,743.15
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,620.20
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,620.20
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,620.20
|
| Rate for Payer: Brighton Health Commercial |
$6,218.29
|
| 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: Humana Medicare |
$3,818.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,743.15
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare 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
|
|
|
REVISION OF NOSE
|
Facility
|
IP
|
$14,691.05
|
|
|
Service Code
|
HCPCS 30435
|
| Hospital Charge Code |
40014382
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,772.21
|
|
|
REVISION OF NOSE
|
Facility
|
OP
|
$14,691.05
|
|
|
Service Code
|
HCPCS 30435
|
| Hospital Charge Code |
40014382
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$11,018.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,772.21
|
| Rate for Payer: Aetna Government |
$6,772.21
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,740.55
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,740.55
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,740.55
|
| Rate for Payer: Brighton Health Commercial |
$11,018.29
|
| Rate for Payer: Cash Price |
$6,772.21
|
| Rate for Payer: Cash Price |
$6,772.21
|
| Rate for Payer: Cash Price |
$6,772.21
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,772.21
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$6,772.21
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,756.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$6,027.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,772.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$6,027.27
|
| Rate for Payer: Group Health Inc Commercial |
$6,772.21
|
| Rate for Payer: Group Health Inc Medicare |
$6,772.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,345.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,772.21
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,756.38
|
| Rate for Payer: Healthfirst QHP |
$6,772.21
|
| Rate for Payer: Humana Medicare |
$6,907.65
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,772.21
|
| Rate for Payer: United Healthcare Commercial |
$2,683.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,772.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,772.21
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,417.77
|
| Rate for Payer: Wellcare Medicare |
$6,433.60
|
|
|
REVISION OF NOSE MAJOR
|
Facility
|
IP
|
$14,691.05
|
|
|
Service Code
|
HCPCS 30450
|
| Hospital Charge Code |
40019649
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,772.21
|
|
|
REVISION OF NOSE MAJOR
|
Facility
|
OP
|
$14,691.05
|
|
|
Service Code
|
HCPCS 30450
|
| Hospital Charge Code |
40019649
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$11,018.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,065.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,772.21
|
| Rate for Payer: Aetna Government |
$6,772.21
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,740.55
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,740.55
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,740.55
|
| Rate for Payer: Brighton Health Commercial |
$11,018.29
|
| Rate for Payer: Cash Price |
$6,772.21
|
| Rate for Payer: Cash Price |
$6,772.21
|
| Rate for Payer: Cash Price |
$6,772.21
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,772.21
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$6,772.21
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,756.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$6,027.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,772.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$6,027.27
|
| Rate for Payer: Group Health Inc Commercial |
$6,772.21
|
| Rate for Payer: Group Health Inc Medicare |
$6,772.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,345.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,772.21
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,756.38
|
| Rate for Payer: Healthfirst QHP |
$6,772.21
|
| Rate for Payer: Humana Medicare |
$6,907.65
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,772.21
|
| Rate for Payer: United Healthcare Commercial |
$2,683.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,772.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,772.21
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,417.77
|
| Rate for Payer: Wellcare Medicare |
$6,433.60
|
|
|
REVISION OF PENIS
|
Facility
|
OP
|
$9,142.40
|
|
|
Service Code
|
HCPCS 54300
|
| Hospital Charge Code |
40014238
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$6,856.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,031.47
|
| Rate for Payer: Aetna Government |
$4,031.47
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,822.03
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,822.03
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,822.03
|
| Rate for Payer: Brighton Health Commercial |
$6,856.80
|
| Rate for Payer: Cash Price |
$4,031.47
|
| Rate for Payer: Cash Price |
$4,031.47
|
| Rate for Payer: Cash Price |
$4,031.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,031.47
|
| 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 |
$4,031.47
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,426.75
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,588.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,031.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,588.01
|
| Rate for Payer: Group Health Inc Commercial |
$4,031.47
|
| Rate for Payer: Group Health Inc Medicare |
$4,031.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,571.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,031.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,426.75
|
| Rate for Payer: Healthfirst QHP |
$4,031.47
|
| Rate for Payer: Humana Medicare |
$4,112.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,031.47
|
| Rate for Payer: United Healthcare Commercial |
$2,683.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,031.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,031.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,225.18
|
| Rate for Payer: Wellcare Medicare |
$3,829.90
|
|
|
REVISION OF PENIS
|
Facility
|
OP
|
$9,142.40
|
|
|
Service Code
|
HCPCS 54435
|
| Hospital Charge Code |
30105870
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$4,571.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,031.47
|
| Rate for Payer: Aetna Government |
$4,031.47
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,822.03
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,822.03
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,822.03
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$4,031.47
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$4,031.47
|
| Rate for Payer: Cash Price |
$4,031.47
|
| Rate for Payer: Cash Price |
$4,031.47
|
| Rate for Payer: Cash Price |
$4,031.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,031.47
|
| 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 |
$4,031.47
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,426.75
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,588.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,031.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,588.01
|
| 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 |
$4,571.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,031.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$4,031.47
|
| Rate for Payer: Humana Medicare |
$4,112.10
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$4,031.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,031.47
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,031.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,031.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,225.18
|
| Rate for Payer: Wellcare Medicare |
$3,829.90
|
|
|
REVISION OF PENIS
|
Facility
|
IP
|
$9,142.40
|
|
|
Service Code
|
HCPCS 54435
|
| Hospital Charge Code |
30105870
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$4,031.47
|
|
|
REVISION OF PENIS
|
Facility
|
IP
|
$9,142.40
|
|
|
Service Code
|
HCPCS 54300
|
| Hospital Charge Code |
40014238
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,031.47
|
|
|
Revision of reconstructed breast (eg, significant removal of tissue, re-advancement and/or re-inset of flaps in autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction)
|
Facility
|
OP
|
$7,691.95
|
|
|
Service Code
|
CPT 19380
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$7,691.95 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$7,541.13
|
| Rate for Payer: Aetna Government |
$7,541.13
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5,278.79
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5,278.79
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5,278.79
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$7,541.13
|
| 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 |
$7,541.13
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$6,409.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$6,711.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$7,541.13
|
| Rate for Payer: Fidelis Qualified Health Plan |
$6,711.61
|
| Rate for Payer: Group Health Inc Commercial |
$7,541.13
|
| Rate for Payer: Group Health Inc Medicare |
$7,541.13
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$7,541.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6,409.96
|
| Rate for Payer: Healthfirst QHP |
$7,541.13
|
| Rate for Payer: Humana Medicare |
$7,691.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$7,541.13
|
| Rate for Payer: United Healthcare Commercial |
$2,683.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,541.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7,541.13
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6,032.90
|
| Rate for Payer: Wellcare Medicare |
$7,164.07
|
|
|
REVISION OF TOE
|
Facility
|
IP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 28312
|
| Hospital Charge Code |
40029677
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,743.15
|
|
|
REVISION OF TOE
|
Facility
|
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 28312
|
| Hospital Charge Code |
40029677
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$6,218.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,743.15
|
| Rate for Payer: Aetna Government |
$3,743.15
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,620.20
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,620.20
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,620.20
|
| Rate for Payer: Brighton Health Commercial |
$6,218.29
|
| 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: Humana Medicare |
$3,818.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,743.15
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare 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
|
|
|
REVISION OF UPPER EYELID
|
Facility
|
OP
|
$4,914.88
|
|
|
Service Code
|
HCPCS 15822
|
| Hospital Charge Code |
40019887
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,409.00 |
| Max. Negotiated Rate |
$3,686.16 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,108.87
|
| Rate for Payer: Aetna Government |
$2,108.87
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,476.21
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,476.21
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,476.21
|
| Rate for Payer: Brighton Health Commercial |
$3,686.16
|
| Rate for Payer: Cash Price |
$2,108.87
|
| Rate for Payer: Cash Price |
$2,108.87
|
| Rate for Payer: Cash Price |
$2,108.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,108.87
|
| 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 |
$2,108.87
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,792.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,876.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,108.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,876.89
|
| Rate for Payer: Group Health Inc Commercial |
$2,108.87
|
| Rate for Payer: Group Health Inc Medicare |
$2,108.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,457.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,108.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,792.54
|
| Rate for Payer: Healthfirst QHP |
$2,108.87
|
| Rate for Payer: Humana Medicare |
$2,151.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,108.87
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,108.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,108.87
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,687.10
|
| Rate for Payer: Wellcare Medicare |
$2,003.43
|
|
|
REVISION OF UPPER EYELID
|
Facility
|
IP
|
$4,914.88
|
|
|
Service Code
|
HCPCS 15822
|
| Hospital Charge Code |
40019887
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$2,108.87
|
|
|
Revision, open, arteriovenous fistula; without thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)
|
Facility
|
OP
|
$6,482.04
|
|
|
Service Code
|
CPT 36832
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$6,482.04 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,354.94
|
| Rate for Payer: Aetna Government |
$6,354.94
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,448.46
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,448.46
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,448.46
|
| 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 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 Medicare |
$6,354.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,401.70
|
| Rate for Payer: Healthfirst QHP |
$6,354.94
|
| Rate for Payer: Humana Medicare |
$6,482.04
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,354.94
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare 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
|
|
|
Revision or removal of peripheral neurostimulator electrode array
|
Facility
|
OP
|
$4,013.46
|
|
|
Service Code
|
CPT 64585
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,412.00 |
| Max. Negotiated Rate |
$4,013.46 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,934.76
|
| Rate for Payer: Aetna Government |
$3,934.76
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,754.33
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,754.33
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,754.33
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,934.76
|
| 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: Elderplan Medicare Advantage |
$3,934.76
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,344.55
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,501.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,934.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,501.94
|
| Rate for Payer: Group Health Inc Commercial |
$3,934.76
|
| Rate for Payer: Group Health Inc Medicare |
$3,934.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,934.76
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,344.55
|
| Rate for Payer: Healthfirst QHP |
$3,934.76
|
| Rate for Payer: Humana Medicare |
$4,013.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,934.76
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,934.76
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,934.76
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,147.81
|
| Rate for Payer: Wellcare Medicare |
$3,738.02
|
|
|
Revision or removal of peripheral, sacral, or gastric neurostimulator pulse generator or receiver, with detachable connection to electrode array
|
Facility
|
OP
|
$4,013.46
|
|
|
Service Code
|
CPT 64595
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,412.00 |
| Max. Negotiated Rate |
$4,013.46 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,934.76
|
| Rate for Payer: Aetna Government |
$3,934.76
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,754.33
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,754.33
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,754.33
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,934.76
|
| 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: Elderplan Medicare Advantage |
$3,934.76
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,344.55
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,501.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,934.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,501.94
|
| Rate for Payer: Group Health Inc Commercial |
$3,934.76
|
| Rate for Payer: Group Health Inc Medicare |
$3,934.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,934.76
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,344.55
|
| Rate for Payer: Healthfirst QHP |
$3,934.76
|
| Rate for Payer: Humana Medicare |
$4,013.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,934.76
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,934.76
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,934.76
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,147.81
|
| Rate for Payer: Wellcare Medicare |
$3,738.02
|
|
|
REVISION TRACHEOSTOMY
|
Facility
|
OP
|
$7,933.18
|
|
|
Service Code
|
HCPCS 31613
|
| Hospital Charge Code |
40011040
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$5,949.88 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,723.23
|
| Rate for Payer: Aetna Government |
$3,723.23
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,606.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,606.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,606.26
|
| Rate for Payer: Brighton Health Commercial |
$5,949.88
|
| Rate for Payer: Cash Price |
$3,723.23
|
| Rate for Payer: Cash Price |
$3,723.23
|
| Rate for Payer: Cash Price |
$3,723.23
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,723.23
|
| 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 |
$3,723.23
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,164.75
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,313.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,723.23
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,313.67
|
| Rate for Payer: Group Health Inc Commercial |
$3,723.23
|
| Rate for Payer: Group Health Inc Medicare |
$3,723.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,966.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,723.23
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,164.75
|
| Rate for Payer: Healthfirst QHP |
$3,723.23
|
| Rate for Payer: Humana Medicare |
$3,797.69
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,723.23
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,723.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,723.23
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,978.58
|
| Rate for Payer: Wellcare Medicare |
$3,537.07
|
|
|
REVISION TRACHEOSTOMY
|
Facility
|
IP
|
$7,933.18
|
|
|
Service Code
|
HCPCS 31613
|
| Hospital Charge Code |
40011040
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,723.23
|
|
|
REVISION UP EYELID W EXCESS SKIN
|
Facility
|
OP
|
$4,914.88
|
|
|
Service Code
|
HCPCS 15823
|
| Hospital Charge Code |
40019818
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,409.00 |
| Max. Negotiated Rate |
$3,686.16 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,108.87
|
| Rate for Payer: Aetna Government |
$2,108.87
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,476.21
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,476.21
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,476.21
|
| Rate for Payer: Brighton Health Commercial |
$3,686.16
|
| Rate for Payer: Cash Price |
$2,108.87
|
| Rate for Payer: Cash Price |
$2,108.87
|
| Rate for Payer: Cash Price |
$2,108.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,108.87
|
| 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 |
$2,108.87
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,792.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,876.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,108.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,876.89
|
| Rate for Payer: Group Health Inc Commercial |
$2,108.87
|
| Rate for Payer: Group Health Inc Medicare |
$2,108.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,457.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,108.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,792.54
|
| Rate for Payer: Healthfirst QHP |
$2,108.87
|
| Rate for Payer: Humana Medicare |
$2,151.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,108.87
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,108.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,108.87
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,687.10
|
| Rate for Payer: Wellcare Medicare |
$2,003.43
|
|
