|
SP HYSTEROSALPINGOGRAM
|
Facility
|
OP
|
$371.20
|
|
|
Service Code
|
HCPCS 58340
|
| Hospital Charge Code |
41542821
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$72.24 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$72.24
|
| Rate for Payer: Aetna Government |
$72.24
|
| Rate for Payer: Brighton Health Commercial |
$278.40
|
| 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: Group Health Inc Commercial |
$185.60
|
| Rate for Payer: Group Health Inc Medicare |
$129.92
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$185.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$185.60
|
|
|
SP ILIAC TRANSLUMBAR
|
Facility
|
IP
|
$48,278.18
|
|
|
Service Code
|
HCPCS 0238T
|
| Hospital Charge Code |
41542768
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$20,278.00
|
|
|
SP ILIAC TRANSLUMBAR
|
Facility
|
OP
|
$48,278.18
|
|
|
Service Code
|
HCPCS 0238T
|
| Hospital Charge Code |
41542768
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,477.75 |
| Max. Negotiated Rate |
$36,208.64 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,065.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$20,278.00
|
| Rate for Payer: Aetna Government |
$20,278.00
|
| Rate for Payer: Brighton Health Commercial |
$36,208.64
|
| Rate for Payer: Cash Price |
$20,278.00
|
| Rate for Payer: Cash Price |
$20,278.00
|
| Rate for Payer: Cash Price |
$20,278.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$20,278.00
|
| 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: Elderplan Medicare Advantage |
$20,278.00
|
| Rate for Payer: EmblemHealth Commercial |
$20,278.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$17,236.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$18,047.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$20,278.00
|
| Rate for Payer: Fidelis Qualified Health Plan |
$18,047.42
|
| Rate for Payer: Group Health Inc Commercial |
$20,278.00
|
| Rate for Payer: Group Health Inc Medicare |
$20,278.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$24,139.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$20,278.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17,236.30
|
| Rate for Payer: Healthfirst QHP |
$20,278.00
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$20,278.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$20,278.00
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$16,222.40
|
| Rate for Payer: Wellcare Medicare |
$19,264.10
|
|
|
SP ILLEOCONDUIT INJECTION
|
Facility
|
OP
|
$301.35
|
|
|
Service Code
|
HCPCS 50690 TC
|
| Hospital Charge Code |
41547641
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$105.47 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$165.74
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$150.68
|
| Rate for Payer: Aetna Government |
$150.68
|
| Rate for Payer: Brighton Health Commercial |
$226.01
|
| 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: Group Health Inc Commercial |
$150.68
|
| Rate for Payer: Group Health Inc Medicare |
$105.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$150.68
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$150.68
|
|
|
SP IMPLANTABLE CHEST PORT
|
Facility
|
IP
|
$8,393.53
|
|
|
Service Code
|
HCPCS 36561 TC
|
| Hospital Charge Code |
41561830
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$3,686.08
|
|
|
SP IMPLANTABLE CHEST PORT
|
Facility
|
OP
|
$8,393.53
|
|
|
Service Code
|
HCPCS 36561 TC
|
| Hospital Charge Code |
41561830
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,477.75 |
| Max. Negotiated Rate |
$6,295.15 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,616.44
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,196.76
|
| Rate for Payer: Aetna Government |
$4,196.76
|
| Rate for Payer: Brighton Health Commercial |
$6,295.15
|
| Rate for Payer: Cash Price |
$3,686.08
|
| Rate for Payer: Cash Price |
$3,686.08
|
| 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: Group Health Inc Commercial |
$4,196.76
|
| Rate for Payer: Group Health Inc Medicare |
$2,937.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,196.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,196.76
|
|
|
SPINAL ACCESSORY NERVE
|
Facility
|
OP
|
$792.83
|
|
|
Service Code
|
HCPCS 64999
|
| Hospital Charge Code |
30305024
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$233.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| 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 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 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
|
|
|
SPINAL ACCESSORY NERVE
|
Facility
|
IP
|
$792.83
|
|
|
Service Code
|
HCPCS 64999
|
| Hospital Charge Code |
30305024
|
|
Hospital Revenue Code
|
510
|
| Rate for Payer: Cash Price |
$342.51
|
|
|
SPINAL CD STIMULATOR MULTI DIG
|
Facility
|
OP
|
$15,915.69
|
|
| Hospital Charge Code |
40205728
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5,570.49 |
| Max. Negotiated Rate |
$12,732.55 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8,753.63
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$7,957.84
|
| Rate for Payer: Aetna Government |
$7,957.84
|
| Rate for Payer: Brighton Health Commercial |
$11,936.77
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$12,732.55
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$10,822.67
|
| Rate for Payer: Group Health Inc Commercial |
$7,957.84
|
| Rate for Payer: Group Health Inc Medicare |
$5,570.49
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,957.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$7,957.84
|
|
|
SPINAL CORD STIM LEAD 50CM 16IN
|
Facility
|
IP
|
$3,006.00
|
|
|
Service Code
|
HCPCS C1778
|
| Hospital Charge Code |
40204561
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,503.00 |
| Max. Negotiated Rate |
$1,503.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,503.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,503.00
|
|
|
SPINAL CORD STIM LEAD 50CM 16IN
|
Facility
|
OP
|
$3,006.00
|
|
|
Service Code
|
HCPCS C1778
|
| Hospital Charge Code |
40204561
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$550.66 |
| Max. Negotiated Rate |
$3,156.30 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,653.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$550.66
|
| Rate for Payer: Aetna Government |
$550.66
|
| Rate for Payer: Brighton Health Commercial |
$1,803.60
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,503.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,728.45
|
| Rate for Payer: EmblemHealth Commercial |
$1,503.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,156.30
|
| Rate for Payer: Group Health Inc Commercial |
$1,503.00
|
| Rate for Payer: Group Health Inc Medicare |
$1,052.10
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,503.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,503.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,953.90
|
|
|
SPINAL CORD STIMULATOR
|
Facility
|
OP
|
$8,482.68
|
|
| Hospital Charge Code |
40205729
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,968.94 |
| Max. Negotiated Rate |
$6,786.14 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,665.47
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,241.34
|
| Rate for Payer: Aetna Government |
$4,241.34
|
| Rate for Payer: Brighton Health Commercial |
$6,362.01
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6,786.14
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$5,768.22
|
| Rate for Payer: Group Health Inc Commercial |
$4,241.34
|
| Rate for Payer: Group Health Inc Medicare |
$2,968.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,241.34
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,241.34
|
|
|
SPINAL DISORDERS AND INJURIES WITH CC/MCC
|
Facility
|
IP
|
$34,978.83
|
|
|
Service Code
|
MSDRG 052
|
| Min. Negotiated Rate |
$15,946.23 |
| Max. Negotiated Rate |
$34,978.83 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$28,671.65
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$34,292.97
|
| Rate for Payer: Aetna Government |
$34,292.97
|
| Rate for Payer: Brighton Health Commercial |
$28,195.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$34,978.83
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$33,579.57
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$27,711.30
|
| Rate for Payer: Elderplan Medicare Advantage |
$32,578.32
|
| Rate for Payer: EmblemHealth Commercial |
$16,674.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$34,292.97
|
| Rate for Payer: Group Health Inc Commercial |
$34,292.97
|
| Rate for Payer: Group Health Inc Medicare |
$34,292.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$34,292.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15,946.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$34,292.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$34,292.97
|
| Rate for Payer: Wellcare Medicare |
$32,578.32
|
|
|
SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC
|
Facility
|
IP
|
$21,389.98
|
|
|
Service Code
|
MSDRG 053
|
| Min. Negotiated Rate |
$8,436.09 |
| Max. Negotiated Rate |
$21,389.98 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$14,506.13
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$20,970.57
|
| Rate for Payer: Aetna Government |
$20,970.57
|
| Rate for Payer: Brighton Health Commercial |
$14,265.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$21,389.98
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$16,989.24
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$14,020.25
|
| Rate for Payer: Elderplan Medicare Advantage |
$19,922.04
|
| Rate for Payer: EmblemHealth Commercial |
$8,436.09
|
| Rate for Payer: Fidelis Medicare Advantage |
$20,970.57
|
| Rate for Payer: Group Health Inc Commercial |
$20,970.57
|
| Rate for Payer: Group Health Inc Medicare |
$20,970.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$20,970.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9,751.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$20,970.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$20,970.57
|
| Rate for Payer: Wellcare Medicare |
$19,922.04
|
|
|
SPINAL FLUID* PROTEIN TOTAL
|
Facility
|
OP
|
$9.18
|
|
|
Service Code
|
HCPCS 84155
|
| Hospital Charge Code |
40602195
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$6.88 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5.05
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.67
|
| Rate for Payer: Aetna Government |
$3.67
|
| Rate for Payer: Brighton Health Commercial |
$6.88
|
| Rate for Payer: Cash Price |
$3.67
|
| Rate for Payer: Cash Price |
$3.67
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.67
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.82
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.93
|
| Rate for Payer: Elderplan Medicare Advantage |
$3.67
|
| Rate for Payer: EmblemHealth Commercial |
$3.67
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.12
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.67
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3.27
|
| Rate for Payer: Group Health Inc Commercial |
$3.67
|
| Rate for Payer: Group Health Inc Medicare |
$3.67
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.67
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.67
|
| Rate for Payer: Healthfirst QHP |
$3.67
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.67
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2.94
|
| Rate for Payer: Wellcare Medicare |
$3.30
|
|
|
SPINAL FLUID* PROTEIN TOTAL
|
Facility
|
IP
|
$9.18
|
|
|
Service Code
|
HCPCS 84155
|
| Hospital Charge Code |
40602195
|
|
Hospital Revenue Code
|
301
|
| Rate for Payer: Cash Price |
$3.67
|
|
|
SPINAL FLUIDS GLUCOSE
|
Facility
|
OP
|
$9.83
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
40602200
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$7.37 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5.41
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.93
|
| Rate for Payer: Aetna Government |
$3.93
|
| Rate for Payer: Brighton Health Commercial |
$7.37
|
| Rate for Payer: Cash Price |
$3.93
|
| Rate for Payer: Cash Price |
$3.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6.24
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$5.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$3.93
|
| Rate for Payer: EmblemHealth Commercial |
$3.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3.50
|
| Rate for Payer: Group Health Inc Commercial |
$3.93
|
| Rate for Payer: Group Health Inc Medicare |
$3.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.93
|
| Rate for Payer: Healthfirst QHP |
$3.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.93
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3.14
|
| Rate for Payer: Wellcare Medicare |
$3.54
|
|
|
SPINAL FLUIDS GLUCOSE
|
Facility
|
IP
|
$9.83
|
|
|
Service Code
|
HCPCS 82945
|
| Hospital Charge Code |
40602200
|
|
Hospital Revenue Code
|
301
|
| Rate for Payer: Cash Price |
$3.93
|
|
|
SPINAL FUSION
|
Facility
|
OP
|
$2,907.69
|
|
|
Service Code
|
HCPCS 22830
|
| Hospital Charge Code |
40021695
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$861.56 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,599.23
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$861.56
|
| Rate for Payer: Aetna Government |
$861.56
|
| Rate for Payer: Brighton Health Commercial |
$2,180.77
|
| 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: Group Health Inc Commercial |
$1,453.84
|
| Rate for Payer: Group Health Inc Medicare |
$1,017.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,453.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,453.84
|
|
|
SPINAL FUSION EXCEPT CERVICAL WITH MCC
|
Facility
|
IP
|
$114,533.19
|
|
|
Service Code
|
MSDRG 459
|
| Min. Negotiated Rate |
$46,174.73 |
| Max. Negotiated Rate |
$114,533.19 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$97,793.26
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$99,300.49
|
| Rate for Payer: Aetna Government |
$99,300.49
|
| Rate for Payer: Brighton Health Commercial |
$96,168.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$101,286.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$114,533.19
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$94,517.70
|
| Rate for Payer: Elderplan Medicare Advantage |
$94,335.47
|
| Rate for Payer: EmblemHealth Commercial |
$56,872.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$99,300.49
|
| Rate for Payer: Group Health Inc Commercial |
$99,300.49
|
| Rate for Payer: Group Health Inc Medicare |
$99,300.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$99,300.49
|
| Rate for Payer: Healthfirst Medicare Advantage |
$46,174.73
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$99,300.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$99,300.49
|
| Rate for Payer: Wellcare Medicare |
$94,335.47
|
|
|
SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC
|
Facility
|
IP
|
$63,168.28
|
|
|
Service Code
|
MSDRG 460
|
| Min. Negotiated Rate |
$26,994.80 |
| Max. Negotiated Rate |
$63,168.28 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$53,935.74
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$58,053.34
|
| Rate for Payer: Aetna Government |
$58,053.34
|
| Rate for Payer: Brighton Health Commercial |
$53,039.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$59,214.41
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$63,168.28
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$52,129.17
|
| Rate for Payer: Elderplan Medicare Advantage |
$55,150.67
|
| Rate for Payer: EmblemHealth Commercial |
$31,366.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$58,053.34
|
| Rate for Payer: Group Health Inc Commercial |
$58,053.34
|
| Rate for Payer: Group Health Inc Medicare |
$58,053.34
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$58,053.34
|
| Rate for Payer: Healthfirst Medicare Advantage |
$26,994.80
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$58,053.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$58,053.34
|
| Rate for Payer: Wellcare Medicare |
$55,150.67
|
|
|
SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC
|
Facility
|
IP
|
$104,914.36
|
|
|
Service Code
|
MSDRG 457
|
| Min. Negotiated Rate |
$42,583.01 |
| Max. Negotiated Rate |
$104,914.36 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$89,580.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$91,576.37
|
| Rate for Payer: Aetna Government |
$91,576.37
|
| Rate for Payer: Brighton Health Commercial |
$88,091.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$93,407.90
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$104,914.36
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$86,579.83
|
| Rate for Payer: Elderplan Medicare Advantage |
$86,997.55
|
| Rate for Payer: EmblemHealth Commercial |
$52,095.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$91,576.37
|
| Rate for Payer: Group Health Inc Commercial |
$91,576.37
|
| Rate for Payer: Group Health Inc Medicare |
$91,576.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$91,576.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$42,583.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$91,576.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$91,576.37
|
| Rate for Payer: Wellcare Medicare |
$86,997.55
|
|
|
SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC
|
Facility
|
IP
|
$145,567.31
|
|
|
Service Code
|
MSDRG 456
|
| Min. Negotiated Rate |
$57,763.03 |
| Max. Negotiated Rate |
$145,567.31 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$124,291.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$124,221.57
|
| Rate for Payer: Aetna Government |
$124,221.57
|
| Rate for Payer: Brighton Health Commercial |
$122,226.30
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$126,706.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$145,567.31
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$120,128.39
|
| Rate for Payer: Elderplan Medicare Advantage |
$118,010.49
|
| Rate for Payer: EmblemHealth Commercial |
$72,282.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$124,221.57
|
| Rate for Payer: Group Health Inc Commercial |
$124,221.57
|
| Rate for Payer: Group Health Inc Medicare |
$124,221.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$124,221.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$57,763.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$124,221.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$124,221.57
|
| Rate for Payer: Wellcare Medicare |
$118,010.49
|
|
|
SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC
|
Facility
|
IP
|
$78,245.84
|
|
|
Service Code
|
MSDRG 458
|
| Min. Negotiated Rate |
$32,624.84 |
| Max. Negotiated Rate |
$78,245.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$66,809.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$70,160.95
|
| Rate for Payer: Aetna Government |
$70,160.95
|
| Rate for Payer: Brighton Health Commercial |
$65,699.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$71,564.17
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$78,245.84
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$64,571.82
|
| Rate for Payer: Elderplan Medicare Advantage |
$66,652.90
|
| Rate for Payer: EmblemHealth Commercial |
$38,853.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$70,160.95
|
| Rate for Payer: Group Health Inc Commercial |
$70,160.95
|
| Rate for Payer: Group Health Inc Medicare |
$70,160.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$70,160.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$32,624.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$70,160.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$70,160.95
|
| Rate for Payer: Wellcare Medicare |
$66,652.90
|
|
|
SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS
|
Facility
|
IP
|
$59,201.59
|
|
|
Service Code
|
MSDRG 029
|
| Min. Negotiated Rate |
$25,513.62 |
| Max. Negotiated Rate |
$59,201.59 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$50,548.81
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$54,868.00
|
| Rate for Payer: Aetna Government |
$54,868.00
|
| Rate for Payer: Brighton Health Commercial |
$49,708.90
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$55,965.36
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$59,201.59
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$48,855.69
|
| Rate for Payer: Elderplan Medicare Advantage |
$52,124.60
|
| Rate for Payer: EmblemHealth Commercial |
$29,396.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$54,868.00
|
| Rate for Payer: Group Health Inc Commercial |
$54,868.00
|
| Rate for Payer: Group Health Inc Medicare |
$54,868.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$54,868.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$25,513.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$54,868.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$54,868.00
|
| Rate for Payer: Wellcare Medicare |
$52,124.60
|
|
