|
BIOPSY-AXILLARY LYMPH NODE
|
Facility
|
OP
|
$9,175.75
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
40010595
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$6,881.81 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,407.98
|
| Rate for Payer: Aetna Government |
$4,407.98
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,085.59
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,085.59
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,085.59
|
| Rate for Payer: Brighton Health Commercial |
$6,881.81
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,407.98
|
| 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 |
$4,407.98
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,746.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,923.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,407.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,923.10
|
| Rate for Payer: Group Health Inc Commercial |
$4,407.98
|
| Rate for Payer: Group Health Inc Medicare |
$4,407.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,587.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,407.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,746.78
|
| Rate for Payer: Healthfirst QHP |
$4,407.98
|
| Rate for Payer: Humana Medicare |
$4,496.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,407.98
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,407.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,407.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,526.38
|
| Rate for Payer: Wellcare Medicare |
$4,187.58
|
|
|
BIOPSY-AXILLARY LYMPH NODE
|
Facility
|
IP
|
$9,175.75
|
|
|
Service Code
|
HCPCS 38525
|
| Hospital Charge Code |
40010595
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,407.98
|
|
|
BIOPSY, BONE, OPEN, SUPERFICIAL
|
Facility
|
IP
|
$7,023.35
|
|
|
Service Code
|
HCPCS 20240
|
| Hospital Charge Code |
30307790
|
|
Hospital Revenue Code
|
510
|
| Rate for Payer: Cash Price |
$3,285.96
|
|
|
BIOPSY, BONE, OPEN, SUPERFICIAL
|
Facility
|
OP
|
$7,023.35
|
|
|
Service Code
|
HCPCS 20240
|
| Hospital Charge Code |
30307790
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$222.00 |
| Max. Negotiated Rate |
$3,511.68 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,285.96
|
| Rate for Payer: Aetna Government |
$3,285.96
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,300.17
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,300.17
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,300.17
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$3,285.96
|
| Rate for Payer: Cash Price |
$3,285.96
|
| Rate for Payer: Cash Price |
$3,285.96
|
| Rate for Payer: Cash Price |
$3,285.96
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,285.96
|
| 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 |
$3,285.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,793.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,924.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,285.96
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,924.50
|
| 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 |
$3,511.68
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,285.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,793.07
|
| Rate for Payer: Healthfirst QHP |
$3,285.96
|
| Rate for Payer: Humana Medicare |
$3,351.68
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,285.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,285.96
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,285.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,285.96
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,628.77
|
| Rate for Payer: Wellcare Medicare |
$3,121.66
|
|
|
Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur)
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 20225
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,312.42 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,312.42
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,312.42
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,312.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Humana Medicare |
$1,912.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur)
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 20225
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,312.42 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,312.42
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,312.42
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,312.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,874.89
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Humana Medicare |
$1,912.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs)
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 20220
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,188.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,312.42
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,312.42
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,312.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,874.89
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Humana Medicare |
$1,912.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: United Healthcare Commercial |
$1,188.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs)
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 20220
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,188.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,312.42
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,312.42
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,312.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Humana Medicare |
$1,912.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: United Healthcare Commercial |
$1,188.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
BIOPSY-BREAST,FROZEN SECTION
|
Facility
|
IP
|
$9,175.75
|
|
|
Service Code
|
HCPCS 19101
|
| Hospital Charge Code |
40010600
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,407.98
|
|
|
BIOPSY-BREAST,FROZEN SECTION
|
Facility
|
OP
|
$9,175.75
|
|
|
Service Code
|
HCPCS 19101
|
| Hospital Charge Code |
40010600
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$6,881.81 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,407.98
|
| Rate for Payer: Aetna Government |
$4,407.98
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,085.59
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,085.59
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,085.59
|
| Rate for Payer: Brighton Health Commercial |
$6,881.81
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,407.98
|
| 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 |
$4,407.98
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,746.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,923.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,407.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,923.10
|
| Rate for Payer: Group Health Inc Commercial |
$4,407.98
|
| Rate for Payer: Group Health Inc Medicare |
$4,407.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,587.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,407.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,746.78
|
| Rate for Payer: Healthfirst QHP |
$4,407.98
|
| Rate for Payer: Humana Medicare |
$4,496.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,407.98
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,407.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,407.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,526.38
|
| Rate for Payer: Wellcare Medicare |
$4,187.58
|
|
|
Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including stereotactic guidance (List separately in addition to code for primary procedure)
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 19082
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$72.75 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$72.75
|
| Rate for Payer: Aetna Government |
$72.75
|
| 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: United Healthcare Commercial |
$1,113.00
|
|
|
Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; each additional lesion, including ultrasound guidance (List separately in addition to code for primary procedure)
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 19084
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$68.16 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$68.16
|
| Rate for Payer: Aetna Government |
$68.16
|
| 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: United Healthcare Commercial |
$1,113.00
|
|
|
Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including stereotactic guidance
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 19081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,312.42 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,312.42
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,312.42
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,312.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,874.89
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Humana Medicare |
$1,912.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including ultrasound guidance
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 19083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,312.42 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,312.42
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,312.42
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,312.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,874.89
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Humana Medicare |
$1,912.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
BIOPSY-CERVICAL LYMPH NODE
|
Facility
|
OP
|
$9,175.75
|
|
|
Service Code
|
HCPCS 38510
|
| Hospital Charge Code |
40010605
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$6,881.81 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,407.98
|
| Rate for Payer: Aetna Government |
$4,407.98
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,085.59
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,085.59
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,085.59
|
| Rate for Payer: Brighton Health Commercial |
$6,881.81
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,407.98
|
| 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 |
$4,407.98
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,746.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,923.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,407.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,923.10
|
| Rate for Payer: Group Health Inc Commercial |
$4,407.98
|
| Rate for Payer: Group Health Inc Medicare |
$4,407.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,587.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,407.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,746.78
|
| Rate for Payer: Healthfirst QHP |
$4,407.98
|
| Rate for Payer: Humana Medicare |
$4,496.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,407.98
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,407.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,407.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,526.38
|
| Rate for Payer: Wellcare Medicare |
$4,187.58
|
|
|
BIOPSY-CERVICAL LYMPH NODE
|
Facility
|
IP
|
$9,175.75
|
|
|
Service Code
|
HCPCS 38510
|
| Hospital Charge Code |
40010605
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,407.98
|
|
|
BIOPSY-CLAVICULAR LYMPH NODE
|
Facility
|
OP
|
$9,175.75
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
40031850
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$6,881.81 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,407.98
|
| Rate for Payer: Aetna Government |
$4,407.98
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,085.59
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,085.59
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,085.59
|
| Rate for Payer: Brighton Health Commercial |
$6,881.81
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Cash Price |
$4,407.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,407.98
|
| 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 |
$4,407.98
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,746.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,923.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,407.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,923.10
|
| Rate for Payer: Group Health Inc Commercial |
$4,407.98
|
| Rate for Payer: Group Health Inc Medicare |
$4,407.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,587.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,407.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,746.78
|
| Rate for Payer: Healthfirst QHP |
$4,407.98
|
| Rate for Payer: Humana Medicare |
$4,496.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,407.98
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,407.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,407.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,526.38
|
| Rate for Payer: Wellcare Medicare |
$4,187.58
|
|
|
BIOPSY-CLAVICULAR LYMPH NODE
|
Facility
|
IP
|
$9,175.75
|
|
|
Service Code
|
HCPCS 38500
|
| Hospital Charge Code |
40031850
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,407.98
|
|
|
BIOPSY CRANIAL FRAMELESS
|
Facility
|
OP
|
$13,250.00
|
|
| Hospital Charge Code |
64905992
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4,637.50 |
| Max. Negotiated Rate |
$10,600.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7,287.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,625.00
|
| Rate for Payer: Aetna Government |
$6,625.00
|
| Rate for Payer: Brighton Health Commercial |
$9,937.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$10,600.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9,010.00
|
| Rate for Payer: Group Health Inc Commercial |
$6,625.00
|
| Rate for Payer: Group Health Inc Medicare |
$4,637.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6,625.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,625.00
|
|
|
BIOPSY-MUSCLE
|
Facility
|
OP
|
$4,157.25
|
|
|
Service Code
|
HCPCS 20200
|
| Hospital Charge Code |
40010610
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,312.42 |
| Max. Negotiated Rate |
$3,117.94 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,312.42
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,312.42
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,312.42
|
| Rate for Payer: Brighton Health Commercial |
$3,117.94
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,078.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Humana Medicare |
$1,912.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
BIOPSY-MUSCLE
|
Facility
|
IP
|
$4,157.25
|
|
|
Service Code
|
HCPCS 20200
|
| Hospital Charge Code |
40010610
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,874.89
|
|
|
BIOPSY-NECK
|
Facility
|
IP
|
$4,157.25
|
|
|
Service Code
|
HCPCS 21550
|
| Hospital Charge Code |
40010615
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,874.89
|
|
|
BIOPSY-NECK
|
Facility
|
OP
|
$4,157.25
|
|
|
Service Code
|
HCPCS 21550
|
| Hospital Charge Code |
40010615
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,312.42 |
| Max. Negotiated Rate |
$3,117.94 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,312.42
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,312.42
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,312.42
|
| Rate for Payer: Brighton Health Commercial |
$3,117.94
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,078.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Humana Medicare |
$1,912.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
BIOPSY OF ANORECTAL WALL, ANAL AP
|
Facility
|
IP
|
$7,099.93
|
|
|
Service Code
|
HCPCS 45100
|
| Hospital Charge Code |
40010701
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,246.99
|
|
|
BIOPSY OF ANORECTAL WALL, ANAL AP
|
Facility
|
OP
|
$7,099.93
|
|
|
Service Code
|
HCPCS 45100
|
| Hospital Charge Code |
40010701
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,409.00 |
| Max. Negotiated Rate |
$5,324.95 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,246.99
|
| Rate for Payer: Aetna Government |
$3,246.99
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,272.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,272.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,272.89
|
| Rate for Payer: Brighton Health Commercial |
$5,324.95
|
| Rate for Payer: Cash Price |
$3,246.99
|
| Rate for Payer: Cash Price |
$3,246.99
|
| Rate for Payer: Cash Price |
$3,246.99
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,246.99
|
| 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 |
$3,246.99
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,759.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,889.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,246.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,889.82
|
| Rate for Payer: Group Health Inc Commercial |
$3,246.99
|
| Rate for Payer: Group Health Inc Medicare |
$3,246.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,549.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,246.99
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,759.94
|
| Rate for Payer: Healthfirst QHP |
$3,246.99
|
| Rate for Payer: Humana Medicare |
$3,311.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,246.99
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,246.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,246.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,597.59
|
| Rate for Payer: Wellcare Medicare |
$3,084.64
|
|
