|
VAG DELIVERY AFTER CESARIAN
|
Facility
OP
|
$7,566.13
|
|
|
Service Code
|
HCPCS 59612
|
| Hospital Charge Code |
30102504
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$3,783.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,615.39
|
| Rate for Payer: Aetna Government |
$3,615.39
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$3,615.39
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,615.39
|
| 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 |
$3,615.39
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,086.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,073.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,217.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,615.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,217.70
|
| 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 |
$3,783.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,615.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$3,615.39
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,615.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,615.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,615.39
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,892.31
|
| Rate for Payer: Wellcare Medicare |
$3,434.62
|
|
|
VAG DELIVERY AFTER CESARIAN
|
Facility
OP
|
$7,566.13
|
|
|
Service Code
|
HCPCS 59612
|
| Hospital Charge Code |
40052241
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,086.55 |
| Max. Negotiated Rate |
$3,783.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,615.39
|
| Rate for Payer: Aetna Government |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,615.39
|
| 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 |
$3,615.39
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,086.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,073.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,217.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,615.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,217.70
|
| Rate for Payer: Group Health Inc Commercial |
$3,615.39
|
| Rate for Payer: Group Health Inc Medicare |
$3,615.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,783.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,615.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,207.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,073.08
|
| Rate for Payer: Healthfirst QHP |
$3,615.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,615.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,615.39
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,892.31
|
| Rate for Payer: Wellcare Medicare |
$3,434.62
|
|
|
VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC
|
Facility
IP
|
$31,182.39
|
|
|
Service Code
|
MS-DRG 746
|
| Min. Negotiated Rate |
$1,000.00 |
| Max. Negotiated Rate |
$31,182.39 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$24,714.09
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$30,570.97
|
| Rate for Payer: Aetna Government |
$30,570.97
|
| Rate for Payer: Brighton Health Commercial |
$24,303.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$31,182.39
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$28,944.57
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$23,886.30
|
| Rate for Payer: Elderplan Medicare Advantage |
$29,042.42
|
| Rate for Payer: EmblemHealth Commercial |
$14,372.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$30,570.97
|
| Rate for Payer: Group Health Inc Commercial |
$1,000.00
|
| Rate for Payer: Group Health Inc Medicare |
$30,570.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30,570.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14,215.50
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$30,570.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$30,570.97
|
| Rate for Payer: Wellcare Medicare |
$29,042.42
|
|
|
VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC
|
Facility
IP
|
$20,023.60
|
|
|
Service Code
|
MS-DRG 747
|
| Min. Negotiated Rate |
$1,000.00 |
| Max. Negotiated Rate |
$20,023.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13,081.76
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$19,630.98
|
| Rate for Payer: Aetna Government |
$19,630.98
|
| Rate for Payer: Brighton Health Commercial |
$12,864.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$20,023.60
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$15,321.06
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12,643.59
|
| Rate for Payer: Elderplan Medicare Advantage |
$18,649.43
|
| Rate for Payer: EmblemHealth Commercial |
$7,607.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$19,630.98
|
| Rate for Payer: Group Health Inc Commercial |
$1,000.00
|
| Rate for Payer: Group Health Inc Medicare |
$19,630.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$19,630.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9,128.41
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$19,630.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$19,630.98
|
| Rate for Payer: Wellcare Medicare |
$18,649.43
|
|
|
VAGINAL DELIVERY ONLY
|
Facility
OP
|
$7,566.13
|
|
|
Service Code
|
HCPCS 59409
|
| Hospital Charge Code |
30102460
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$3,783.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,615.39
|
| Rate for Payer: Aetna Government |
$3,615.39
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$3,615.39
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,615.39
|
| 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 |
$3,615.39
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$945.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,073.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,217.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,615.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,217.70
|
| 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 |
$3,783.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,615.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$3,615.39
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,615.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,615.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,615.39
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,892.31
|
| Rate for Payer: Wellcare Medicare |
$3,434.62
|
|
|
VAGINAL DELIVERY ONLY
|
Facility
OP
|
$7,566.13
|
|
|
Service Code
|
HCPCS 59409
|
| Hospital Charge Code |
30302460
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$3,783.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,615.39
|
| Rate for Payer: Aetna Government |
$3,615.39
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$3,615.39
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,615.39
|
| 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 |
$3,615.39
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$945.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,073.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,217.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,615.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,217.70
|
| 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 |
$3,783.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,615.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$3,615.39
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,615.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,615.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,615.39
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,892.31
|
| Rate for Payer: Wellcare Medicare |
$3,434.62
|
|
|
VAGINAL DELIVERY ONLY
|
Facility
OP
|
$7,566.13
|
|
|
Service Code
|
HCPCS 59409
|
| Hospital Charge Code |
30102501
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$3,783.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,615.39
|
| Rate for Payer: Aetna Government |
$3,615.39
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$3,615.39
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,615.39
|
| 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 |
$3,615.39
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$945.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,073.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,217.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,615.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,217.70
|
| 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 |
$3,783.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,615.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$3,615.39
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,615.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,615.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,615.39
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,892.31
|
| Rate for Payer: Wellcare Medicare |
$3,434.62
|
|
|
VAGINAL DELIVERY ONLY
|
Facility
OP
|
$7,566.13
|
|
|
Service Code
|
HCPCS 59409
|
| Hospital Charge Code |
40019719
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$945.20 |
| Max. Negotiated Rate |
$3,783.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,615.39
|
| Rate for Payer: Aetna Government |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Cash Price |
$3,615.39
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,615.39
|
| 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 |
$3,615.39
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$945.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,073.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,217.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,615.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,217.70
|
| Rate for Payer: Group Health Inc Commercial |
$3,615.39
|
| Rate for Payer: Group Health Inc Medicare |
$3,615.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,783.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,615.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,050.22
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,073.08
|
| Rate for Payer: Healthfirst QHP |
$3,615.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,615.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,615.39
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,892.31
|
| Rate for Payer: Wellcare Medicare |
$3,434.62
|
|
|
VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C
|
Facility
IP
|
$24,704.09
|
|
|
Service Code
|
MS-DRG 768
|
| Min. Negotiated Rate |
$5,045.00 |
| Max. Negotiated Rate |
$24,704.09 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17,960.88
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$24,219.70
|
| Rate for Payer: Aetna Government |
$24,219.70
|
| Rate for Payer: Brighton Health Commercial |
$17,662.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$24,704.09
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$21,035.37
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17,359.29
|
| Rate for Payer: Elderplan Medicare Advantage |
$23,008.72
|
| Rate for Payer: EmblemHealth Commercial |
$5,045.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$24,219.70
|
| Rate for Payer: Group Health Inc Commercial |
$7,000.00
|
| Rate for Payer: Group Health Inc Medicare |
$24,219.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$24,219.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11,262.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$24,219.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$24,219.70
|
| Rate for Payer: Wellcare Medicare |
$23,008.72
|
|
|
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC
|
Facility
IP
|
$18,036.28
|
|
|
Service Code
|
MS-DRG 806
|
| Min. Negotiated Rate |
$6,402.95 |
| Max. Negotiated Rate |
$18,036.28 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11,010.09
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17,682.63
|
| Rate for Payer: Aetna Government |
$17,682.63
|
| Rate for Payer: Brighton Health Commercial |
$10,827.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$18,036.28
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$12,894.76
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$10,641.31
|
| Rate for Payer: Elderplan Medicare Advantage |
$16,798.50
|
| Rate for Payer: EmblemHealth Commercial |
$6,402.95
|
| Rate for Payer: Fidelis Medicare Advantage |
$17,682.63
|
| Rate for Payer: Group Health Inc Commercial |
$17,682.63
|
| Rate for Payer: Group Health Inc Medicare |
$17,682.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17,682.63
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8,222.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17,682.63
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17,682.63
|
| Rate for Payer: Wellcare Medicare |
$16,798.50
|
|
|
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC
|
Facility
IP
|
$21,735.12
|
|
|
Service Code
|
MS-DRG 805
|
| Min. Negotiated Rate |
$8,645.32 |
| Max. Negotiated Rate |
$21,735.12 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$14,865.91
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$21,308.94
|
| Rate for Payer: Aetna Government |
$21,308.94
|
| Rate for Payer: Brighton Health Commercial |
$14,618.90
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$21,735.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$17,410.61
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$14,367.98
|
| Rate for Payer: Elderplan Medicare Advantage |
$20,243.49
|
| Rate for Payer: EmblemHealth Commercial |
$8,645.32
|
| Rate for Payer: Fidelis Medicare Advantage |
$21,308.94
|
| Rate for Payer: Group Health Inc Commercial |
$21,308.94
|
| Rate for Payer: Group Health Inc Medicare |
$21,308.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21,308.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9,908.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$21,308.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21,308.94
|
| Rate for Payer: Wellcare Medicare |
$20,243.49
|
|
|
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC
|
Facility
IP
|
$16,729.30
|
|
|
Service Code
|
MS-DRG 807
|
| Min. Negotiated Rate |
$5,610.62 |
| Max. Negotiated Rate |
$16,729.30 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$9,647.65
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16,401.27
|
| Rate for Payer: Aetna Government |
$16,401.27
|
| Rate for Payer: Brighton Health Commercial |
$9,487.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$16,729.30
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$11,299.11
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9,324.51
|
| Rate for Payer: Elderplan Medicare Advantage |
$15,581.21
|
| Rate for Payer: EmblemHealth Commercial |
$5,610.62
|
| Rate for Payer: Fidelis Medicare Advantage |
$16,401.27
|
| Rate for Payer: Group Health Inc Commercial |
$16,401.27
|
| Rate for Payer: Group Health Inc Medicare |
$16,401.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16,401.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,626.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$16,401.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16,401.27
|
| Rate for Payer: Wellcare Medicare |
$15,581.21
|
|
|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC
|
Facility
IP
|
$21,561.15
|
|
|
Service Code
|
MS-DRG 797
|
| Min. Negotiated Rate |
$8,539.84 |
| Max. Negotiated Rate |
$21,561.15 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$14,684.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$21,138.38
|
| Rate for Payer: Aetna Government |
$21,138.38
|
| Rate for Payer: Brighton Health Commercial |
$14,440.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$21,561.15
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$17,198.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$14,192.69
|
| Rate for Payer: Elderplan Medicare Advantage |
$20,081.46
|
| Rate for Payer: EmblemHealth Commercial |
$8,539.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$21,138.38
|
| Rate for Payer: Group Health Inc Commercial |
$21,138.38
|
| Rate for Payer: Group Health Inc Medicare |
$21,138.38
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21,138.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9,829.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$21,138.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21,138.38
|
| Rate for Payer: Wellcare Medicare |
$20,081.46
|
|
|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC
|
Facility
IP
|
$27,537.28
|
|
|
Service Code
|
MS-DRG 796
|
| Min. Negotiated Rate |
$12,162.80 |
| Max. Negotiated Rate |
$27,537.28 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$20,914.31
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$26,997.33
|
| Rate for Payer: Aetna Government |
$26,997.33
|
| Rate for Payer: Brighton Health Commercial |
$20,566.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$27,537.28
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$24,494.35
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$20,213.79
|
| Rate for Payer: Elderplan Medicare Advantage |
$25,647.46
|
| Rate for Payer: EmblemHealth Commercial |
$12,162.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$26,997.33
|
| Rate for Payer: Group Health Inc Commercial |
$26,997.33
|
| Rate for Payer: Group Health Inc Medicare |
$26,997.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26,997.33
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12,553.76
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26,997.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26,997.33
|
| Rate for Payer: Wellcare Medicare |
$25,647.46
|
|
|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC
|
Facility
IP
|
$19,286.66
|
|
|
Service Code
|
MS-DRG 798
|
| Min. Negotiated Rate |
$6,956.04 |
| Max. Negotiated Rate |
$19,286.66 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11,961.14
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$18,908.49
|
| Rate for Payer: Aetna Government |
$18,908.49
|
| Rate for Payer: Brighton Health Commercial |
$11,762.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$19,286.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$14,421.34
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11,901.11
|
| Rate for Payer: Elderplan Medicare Advantage |
$17,963.07
|
| Rate for Payer: EmblemHealth Commercial |
$6,956.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$18,908.49
|
| Rate for Payer: Group Health Inc Commercial |
$18,908.49
|
| Rate for Payer: Group Health Inc Medicare |
$18,908.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18,908.49
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8,792.45
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$18,908.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$18,908.49
|
| Rate for Payer: Wellcare Medicare |
$17,963.07
|
|
|
VAGINAL DELIVRY INCL ANTE/POSTPAR
|
Facility
OP
|
$8,701.05
|
|
|
Service Code
|
HCPCS 59400
|
| Hospital Charge Code |
40002233
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$4,785.58 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,785.58
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,473.00
|
| Rate for Payer: Aetna Government |
$2,473.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,810.89
|
| Rate for Payer: Group Health Inc Commercial |
$4,350.52
|
| Rate for Payer: Group Health Inc Medicare |
$3,045.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,350.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,350.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3,123.21
|
|
|
VAGINAL EXAMINATION TRAY
|
Facility
OP
|
$25.52
|
|
| Hospital Charge Code |
40206610
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.93 |
| Max. Negotiated Rate |
$20.42 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$14.04
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.76
|
| Rate for Payer: Aetna Government |
$12.76
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.42
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.35
|
| Rate for Payer: Group Health Inc Commercial |
$12.76
|
| Rate for Payer: Group Health Inc Medicare |
$8.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.76
|
|
|
VAGINAL HYSTERECTOMY
|
Facility
OP
|
$12,937.43
|
|
|
Service Code
|
HCPCS 58260
|
| Hospital Charge Code |
40052280
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$941.65 |
| Max. Negotiated Rate |
$6,468.72 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5,751.94
|
| Rate for Payer: Aetna Government |
$5,751.94
|
| Rate for Payer: Cash Price |
$5,751.94
|
| Rate for Payer: Cash Price |
$5,751.94
|
| Rate for Payer: Cash Price |
$5,751.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5,751.94
|
| 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 |
$5,751.94
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$941.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4,889.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,119.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$5,751.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,119.23
|
| Rate for Payer: Group Health Inc Commercial |
$5,751.94
|
| Rate for Payer: Group Health Inc Medicare |
$5,751.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6,468.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5,751.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,046.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$4,889.15
|
| Rate for Payer: Healthfirst QHP |
$5,751.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5,751.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5,751.94
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4,601.55
|
| Rate for Payer: Wellcare Medicare |
$5,464.34
|
|
|
VAGINAL L&D CHARGE
|
Facility
OP
|
$1,700.00
|
|
| Hospital Charge Code |
40251100
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$595.00 |
| Max. Negotiated Rate |
$1,360.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$935.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$850.00
|
| Rate for Payer: Aetna Government |
$850.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,360.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,156.00
|
| Rate for Payer: Group Health Inc Commercial |
$850.00
|
| Rate for Payer: Group Health Inc Medicare |
$595.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$850.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$850.00
|
|
|
VAGINAL SPECULUM
|
Facility
OP
|
$6.73
|
|
| Hospital Charge Code |
40207616
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.36 |
| Max. Negotiated Rate |
$5.38 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.36
|
| Rate for Payer: Aetna Government |
$3.36
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.38
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.58
|
| Rate for Payer: Group Health Inc Commercial |
$3.36
|
| Rate for Payer: Group Health Inc Medicare |
$2.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.36
|
|
|
VAGOTOMY, PYLOROPLASTY
|
Facility
OP
|
$3,239.70
|
|
|
Service Code
|
HCPCS 43640
|
| Hospital Charge Code |
40011080
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,133.90 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,781.84
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,401.25
|
| Rate for Payer: Aetna Government |
$1,401.25
|
| 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 |
$1,387.58
|
| Rate for Payer: Group Health Inc Commercial |
$1,619.85
|
| Rate for Payer: Group Health Inc Medicare |
$1,133.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,619.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,619.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,541.75
|
|
|
VAGUS NERVE
|
Facility
OP
|
$792.83
|
|
|
Service Code
|
HCPCS 64408
|
| Hospital Charge Code |
30305023
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$49.64 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$342.51
|
| Rate for Payer: Aetna Government |
$342.51
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$342.51
|
| Rate for Payer: Cash Price |
$342.51
|
| Rate for Payer: Cash Price |
$342.51
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$342.51
|
| 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 |
$342.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$49.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$291.13
|
| Rate for Payer: Fidelis Essential Plan QHP |
$304.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$342.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$304.83
|
| Rate for Payer: Group Health Inc Commercial |
$250.00
|
| Rate for Payer: Group Health Inc Medicare |
$250.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$396.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$342.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$55.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$291.13
|
| Rate for Payer: Healthfirst QHP |
$342.51
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$342.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$342.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$342.51
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$274.01
|
| Rate for Payer: Wellcare Medicare |
$325.38
|
|
|
VALACYCLOVIR HCL 500MG TABLET
|
Facility
OP
|
$7.30
|
|
| Hospital Charge Code |
41650312
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.56 |
| Max. Negotiated Rate |
$5.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.02
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.65
|
| Rate for Payer: Aetna Government |
$3.65
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.84
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.96
|
| Rate for Payer: Group Health Inc Commercial |
$3.65
|
| Rate for Payer: Group Health Inc Medicare |
$2.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.74
|
|
|
VALACYCLOVIR HCL 500MG TABLET
|
Facility
OP
|
$7.30
|
|
| Hospital Charge Code |
41640312
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.56 |
| Max. Negotiated Rate |
$5.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.02
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.65
|
| Rate for Payer: Aetna Government |
$3.65
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.84
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.96
|
| Rate for Payer: Group Health Inc Commercial |
$3.65
|
| Rate for Payer: Group Health Inc Medicare |
$2.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.74
|
|
|
VALGANCICLOVIR 450 MG TAB
|
Facility
IP
|
$95.50
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
41642623
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$47.75 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$47.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$47.75
|
|
