|
URETEROLYSIS-VAG VEIN
|
Facility
OP
|
$2,749.40
|
|
|
Service Code
|
HCPCS 50722
|
| Hospital Charge Code |
40129504
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$962.29 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,512.17
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,246.67
|
| Rate for Payer: Aetna Government |
$1,246.67
|
| 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 |
$1,140.12
|
| Rate for Payer: Group Health Inc Commercial |
$1,374.70
|
| Rate for Payer: Group Health Inc Medicare |
$962.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,374.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,374.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,266.80
|
|
|
URETEROSTOMY
|
Facility
OP
|
$419.03
|
|
|
Service Code
|
HCPCS 50686
|
| Hospital Charge Code |
40123115
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$94.56 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$180.64
|
| Rate for Payer: Aetna Government |
$180.64
|
| Rate for Payer: Cash Price |
$180.64
|
| Rate for Payer: Cash Price |
$180.64
|
| Rate for Payer: Cash Price |
$180.64
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$180.64
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$180.64
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$94.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$153.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$160.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$180.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$160.77
|
| Rate for Payer: Group Health Inc Commercial |
$180.64
|
| Rate for Payer: Group Health Inc Medicare |
$180.64
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$209.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$180.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$105.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$153.54
|
| Rate for Payer: Healthfirst QHP |
$180.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$180.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$180.64
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$144.51
|
| Rate for Payer: Wellcare Medicare |
$171.61
|
|
|
URETHRAL CATHETERS
|
Facility
OP
|
$4.25
|
|
| Hospital Charge Code |
40000415
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.49 |
| Max. Negotiated Rate |
$3.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2.34
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2.12
|
| Rate for Payer: Aetna Government |
$2.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.40
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2.89
|
| Rate for Payer: Group Health Inc Commercial |
$2.12
|
| Rate for Payer: Group Health Inc Medicare |
$1.49
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2.12
|
|
|
URETHRAL CATHETER TRAY
|
Facility
OP
|
$17.01
|
|
| Hospital Charge Code |
40206340
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.95 |
| Max. Negotiated Rate |
$13.61 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$9.36
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.50
|
| Rate for Payer: Aetna Government |
$8.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.61
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.57
|
| Rate for Payer: Group Health Inc Commercial |
$8.50
|
| Rate for Payer: Group Health Inc Medicare |
$5.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.50
|
|
|
URETHRAL PROCEDURES WITH CC/MCC
|
Facility
IP
|
$31,688.77
|
|
|
Service Code
|
MS-DRG 671
|
| Min. Negotiated Rate |
$14,446.35 |
| Max. Negotiated Rate |
$31,688.77 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$25,241.97
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$31,067.42
|
| Rate for Payer: Aetna Government |
$31,067.42
|
| Rate for Payer: Brighton Health Commercial |
$24,822.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$31,688.77
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$29,562.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$24,396.49
|
| Rate for Payer: Elderplan Medicare Advantage |
$29,514.05
|
| Rate for Payer: EmblemHealth Commercial |
$14,679.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$31,067.42
|
| Rate for Payer: Group Health Inc Commercial |
$31,067.42
|
| Rate for Payer: Group Health Inc Medicare |
$31,067.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$31,067.42
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14,446.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$31,067.42
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$31,067.42
|
| Rate for Payer: Wellcare Medicare |
$29,514.05
|
|
|
URETHRAL PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$20,735.11
|
|
|
Service Code
|
MS-DRG 672
|
| Min. Negotiated Rate |
$7,912.15 |
| Max. Negotiated Rate |
$20,735.11 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13,605.21
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$20,328.54
|
| Rate for Payer: Aetna Government |
$20,328.54
|
| Rate for Payer: Brighton Health Commercial |
$13,379.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$20,735.11
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$16,189.69
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$13,360.43
|
| Rate for Payer: Elderplan Medicare Advantage |
$19,312.11
|
| Rate for Payer: EmblemHealth Commercial |
$7,912.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$20,328.54
|
| Rate for Payer: Group Health Inc Commercial |
$20,328.54
|
| Rate for Payer: Group Health Inc Medicare |
$20,328.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$20,328.54
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9,452.77
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$20,328.54
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$20,328.54
|
| Rate for Payer: Wellcare Medicare |
$19,312.11
|
|
|
URETHRAL SLING
|
Facility
IP
|
$1,990.00
|
|
|
Service Code
|
HCPCS C1771
|
| Hospital Charge Code |
40201005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$995.00 |
| Max. Negotiated Rate |
$995.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$995.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$995.00
|
|
|
URETHRAL SLING
|
Facility
OP
|
$1,990.00
|
|
|
Service Code
|
HCPCS C1771
|
| Hospital Charge Code |
40201005
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$560.38 |
| Max. Negotiated Rate |
$2,089.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,094.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$560.38
|
| Rate for Payer: Aetna Government |
$560.38
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$995.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,144.25
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,089.50
|
| Rate for Payer: Group Health Inc Commercial |
$995.00
|
| Rate for Payer: Group Health Inc Medicare |
$696.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$995.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$995.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,293.50
|
|
|
URETHRAL STRICTURE
|
Facility
IP
|
$23,218.89
|
|
|
Service Code
|
MS-DRG 697
|
| Min. Negotiated Rate |
$9,544.83 |
| Max. Negotiated Rate |
$23,218.89 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$16,412.66
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$22,763.62
|
| Rate for Payer: Aetna Government |
$22,763.62
|
| Rate for Payer: Brighton Health Commercial |
$16,139.95
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$23,218.89
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$19,222.12
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$15,862.92
|
| Rate for Payer: Elderplan Medicare Advantage |
$21,625.44
|
| Rate for Payer: EmblemHealth Commercial |
$9,544.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$22,763.62
|
| Rate for Payer: Group Health Inc Commercial |
$22,763.62
|
| Rate for Payer: Group Health Inc Medicare |
$22,763.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$22,763.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,585.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$22,763.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$22,763.62
|
| Rate for Payer: Wellcare Medicare |
$21,625.44
|
|
|
URETHRO VESICAL SUSPENSION
|
Facility
OP
|
$3,791.19
|
|
|
Service Code
|
HCPCS 50400
|
| Hospital Charge Code |
40123065
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,238.26 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,085.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,412.10
|
| Rate for Payer: Aetna Government |
$1,412.10
|
| 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 |
$1,238.26
|
| Rate for Payer: Group Health Inc Commercial |
$1,895.60
|
| Rate for Payer: Group Health Inc Medicare |
$1,326.92
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,895.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,895.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,375.85
|
|
|
Urgent Care Global Code
|
Facility
OP
|
$165.00
|
|
|
Service Code
|
HCPCS S9083
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$165.00 |
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$165.00
|
|
|
URIC ACID
|
Facility
OP
|
$11.30
|
|
|
Service Code
|
HCPCS 84550
|
| Hospital Charge Code |
40602110
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$7.19 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$6.22
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.52
|
| Rate for Payer: Aetna Government |
$4.52
|
| Rate for Payer: Cash Price |
$4.52
|
| Rate for Payer: Cash Price |
$4.52
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4.52
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$7.19
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.08
|
| Rate for Payer: Elderplan Medicare Advantage |
$4.52
|
| Rate for Payer: EmblemHealth Commercial |
$4.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.02
|
| Rate for Payer: Fidelis Medicare Advantage |
$4.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.02
|
| Rate for Payer: Group Health Inc Commercial |
$4.52
|
| Rate for Payer: Group Health Inc Medicare |
$4.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$4.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$4.52
|
| Rate for Payer: Healthfirst QHP |
$4.52
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.52
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.62
|
| Rate for Payer: Wellcare Medicare |
$4.07
|
|
|
URIC ACID 24 HOUR URINE
|
Facility
OP
|
$12.70
|
|
|
Service Code
|
HCPCS 84560
|
| Hospital Charge Code |
40602630
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.06 |
| Max. Negotiated Rate |
$7.54 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$6.98
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.08
|
| Rate for Payer: Aetna Government |
$5.08
|
| Rate for Payer: Cash Price |
$5.08
|
| Rate for Payer: Cash Price |
$5.08
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$7.54
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.38
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.08
|
| Rate for Payer: EmblemHealth Commercial |
$5.08
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.57
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.32
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.52
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.52
|
| Rate for Payer: Group Health Inc Commercial |
$5.08
|
| Rate for Payer: Group Health Inc Medicare |
$5.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.08
|
| Rate for Payer: Healthfirst QHP |
$5.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.08
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.06
|
| Rate for Payer: Wellcare Medicare |
$4.57
|
|
|
URI-METER
|
Facility
OP
|
$17.01
|
|
| Hospital Charge Code |
40206350
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.95 |
| Max. Negotiated Rate |
$13.61 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$9.36
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.50
|
| Rate for Payer: Aetna Government |
$8.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.61
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.57
|
| Rate for Payer: Group Health Inc Commercial |
$8.50
|
| Rate for Payer: Group Health Inc Medicare |
$5.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.50
|
|
|
URIMETER
|
Facility
OP
|
$8.15
|
|
| Hospital Charge Code |
40196350
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$2.85 |
| Max. Negotiated Rate |
$6.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.48
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.08
|
| Rate for Payer: Aetna Government |
$4.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$5.54
|
| Rate for Payer: Group Health Inc Commercial |
$4.08
|
| Rate for Payer: Group Health Inc Medicare |
$2.85
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.08
|
|
|
URIMETER
|
Facility
OP
|
$10.28
|
|
| Hospital Charge Code |
40000420
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$8.22 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5.65
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.14
|
| Rate for Payer: Aetna Government |
$5.14
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.22
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.99
|
| Rate for Payer: Group Health Inc Commercial |
$5.14
|
| Rate for Payer: Group Health Inc Medicare |
$3.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.14
|
|
|
URINAL MALE CLEAR DLX W/COVER
|
Facility
OP
|
$0.91
|
|
| Hospital Charge Code |
64901835
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.32 |
| Max. Negotiated Rate |
$0.73 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.46
|
| Rate for Payer: Aetna Government |
$0.46
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.73
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.62
|
| Rate for Payer: Group Health Inc Commercial |
$0.46
|
| Rate for Payer: Group Health Inc Medicare |
$0.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.46
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.46
|
|
|
URINAL-MBO,W/LID,DLX,HANGING
|
Facility
OP
|
$0.91
|
|
| Hospital Charge Code |
64902134
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$0.32 |
| Max. Negotiated Rate |
$0.73 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.46
|
| Rate for Payer: Aetna Government |
$0.46
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.73
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.62
|
| Rate for Payer: Group Health Inc Commercial |
$0.46
|
| Rate for Payer: Group Health Inc Medicare |
$0.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.46
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.46
|
|
|
URINAL PLASTIC
|
Facility
OP
|
$33.32
|
|
| Hospital Charge Code |
40206370
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.66 |
| Max. Negotiated Rate |
$26.66 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$18.33
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16.66
|
| Rate for Payer: Aetna Government |
$16.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$26.66
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$22.66
|
| Rate for Payer: Group Health Inc Commercial |
$16.66
|
| Rate for Payer: Group Health Inc Medicare |
$11.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.66
|
|
|
URINALYSIS, COMPLETE
|
Facility
OP
|
$7.93
|
|
|
Service Code
|
HCPCS 81001
|
| Hospital Charge Code |
40629824
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$5.03 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.36
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.17
|
| Rate for Payer: Aetna Government |
$3.17
|
| Rate for Payer: Cash Price |
$3.17
|
| Rate for Payer: Cash Price |
$3.17
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.17
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.03
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.26
|
| Rate for Payer: Elderplan Medicare Advantage |
$3.17
|
| Rate for Payer: EmblemHealth Commercial |
$3.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2.85
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2.82
|
| Rate for Payer: Group Health Inc Commercial |
$3.17
|
| Rate for Payer: Group Health Inc Medicare |
$3.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.17
|
| Rate for Payer: Healthfirst QHP |
$3.17
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.17
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.17
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2.54
|
| Rate for Payer: Wellcare Medicare |
$2.85
|
|
|
URINALYSIS DIP STICK
|
Facility
OP
|
$10.05
|
|
|
Service Code
|
HCPCS 81000
|
| Hospital Charge Code |
30301271
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.22 |
| Max. Negotiated Rate |
$5.53 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5.53
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.02
|
| Rate for Payer: Aetna Government |
$4.02
|
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4.02
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.03
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.26
|
| Rate for Payer: Elderplan Medicare Advantage |
$4.02
|
| Rate for Payer: EmblemHealth Commercial |
$4.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3.62
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.42
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$4.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3.58
|
| Rate for Payer: Group Health Inc Commercial |
$4.02
|
| Rate for Payer: Group Health Inc Medicare |
$4.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$4.02
|
| Rate for Payer: Healthfirst Medicare Advantage |
$4.02
|
| Rate for Payer: Healthfirst QHP |
$4.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.02
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.22
|
| Rate for Payer: Wellcare Medicare |
$3.62
|
|
|
URINARY CALCIUM QUANTITATIVE
|
Facility
OP
|
$15.08
|
|
|
Service Code
|
HCPCS 82340
|
| Hospital Charge Code |
40602250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.82 |
| Max. Negotiated Rate |
$9.58 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8.29
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6.03
|
| Rate for Payer: Aetna Government |
$6.03
|
| Rate for Payer: Cash Price |
$6.03
|
| Rate for Payer: Cash Price |
$6.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6.03
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$9.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$8.11
|
| Rate for Payer: Elderplan Medicare Advantage |
$6.03
|
| Rate for Payer: EmblemHealth Commercial |
$6.03
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$5.43
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5.13
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$6.03
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5.37
|
| Rate for Payer: Group Health Inc Commercial |
$6.03
|
| Rate for Payer: Group Health Inc Medicare |
$6.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.03
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$6.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6.03
|
| Rate for Payer: Healthfirst QHP |
$6.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6.03
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.82
|
| Rate for Payer: Wellcare Medicare |
$5.43
|
|
|
URINARY CREATININE
|
Facility
OP
|
$12.95
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
40602260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.14 |
| Max. Negotiated Rate |
$8.23 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.12
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.18
|
| Rate for Payer: Aetna Government |
$5.18
|
| Rate for Payer: Cash Price |
$5.18
|
| Rate for Payer: Cash Price |
$5.18
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.18
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.23
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.96
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.18
|
| Rate for Payer: EmblemHealth Commercial |
$5.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.61
|
| Rate for Payer: Group Health Inc Commercial |
$5.18
|
| Rate for Payer: Group Health Inc Medicare |
$5.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.18
|
| Rate for Payer: Healthfirst QHP |
$5.18
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.18
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.18
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.14
|
| Rate for Payer: Wellcare Medicare |
$4.66
|
|
|
URINARY DRAINAGE BAG
|
Facility
OP
|
$10.28
|
|
| Hospital Charge Code |
40000425
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$8.22 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5.65
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.14
|
| Rate for Payer: Aetna Government |
$5.14
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.22
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.99
|
| Rate for Payer: Group Health Inc Commercial |
$5.14
|
| Rate for Payer: Group Health Inc Medicare |
$3.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.14
|
|
|
URINARY DRAINAGE BAG
|
Facility
OP
|
$8.15
|
|
| Hospital Charge Code |
40191222
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$2.85 |
| Max. Negotiated Rate |
$6.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.48
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.08
|
| Rate for Payer: Aetna Government |
$4.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$5.54
|
| Rate for Payer: Group Health Inc Commercial |
$4.08
|
| Rate for Payer: Group Health Inc Medicare |
$2.85
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.08
|
|
