|
THROMB+TBA PERIPH DIALYSIS SEG
|
Facility
|
OP
|
$30,010.30
|
|
|
Service Code
|
HCPCS 36905
|
| Hospital Charge Code |
66524702
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,477.75 |
| Max. Negotiated Rate |
$22,507.72 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5,593.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12,721.98
|
| Rate for Payer: Aetna Government |
$12,721.98
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8,905.39
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8,905.39
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8,905.39
|
| Rate for Payer: Brighton Health Commercial |
$22,507.72
|
| Rate for Payer: Cash Price |
$12,721.98
|
| Rate for Payer: Cash Price |
$12,721.98
|
| Rate for Payer: Cash Price |
$12,721.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12,721.98
|
| 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 |
$12,721.98
|
| Rate for Payer: EmblemHealth Commercial |
$12,721.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10,813.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11,322.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$12,721.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11,322.56
|
| Rate for Payer: Group Health Inc Commercial |
$12,721.98
|
| Rate for Payer: Group Health Inc Medicare |
$12,721.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15,005.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12,721.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,813.68
|
| Rate for Payer: Healthfirst QHP |
$12,721.98
|
| Rate for Payer: Humana Medicare |
$12,976.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12,721.98
|
| Rate for Payer: United Healthcare Commercial |
$3,190.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,721.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12,721.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10,177.58
|
| Rate for Payer: Wellcare Medicare |
$12,085.88
|
|
|
THROMB+TBA PERIPH DIALYSIS SEG
|
Facility
|
IP
|
$30,010.30
|
|
|
Service Code
|
HCPCS 36905
|
| Hospital Charge Code |
40034507
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$12,721.98
|
|
|
THROMB+TBA PERIPH DIALYSIS SEG
|
Facility
|
OP
|
$30,010.30
|
|
|
Service Code
|
HCPCS 36905
|
| Hospital Charge Code |
40034507
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,477.75 |
| Max. Negotiated Rate |
$22,507.72 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5,593.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12,721.98
|
| Rate for Payer: Aetna Government |
$12,721.98
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8,905.39
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8,905.39
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8,905.39
|
| Rate for Payer: Brighton Health Commercial |
$22,507.72
|
| Rate for Payer: Cash Price |
$12,721.98
|
| Rate for Payer: Cash Price |
$12,721.98
|
| Rate for Payer: Cash Price |
$12,721.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12,721.98
|
| 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 |
$12,721.98
|
| Rate for Payer: EmblemHealth Commercial |
$12,721.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10,813.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11,322.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$12,721.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11,322.56
|
| Rate for Payer: Group Health Inc Commercial |
$12,721.98
|
| Rate for Payer: Group Health Inc Medicare |
$12,721.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15,005.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12,721.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,813.68
|
| Rate for Payer: Healthfirst QHP |
$12,721.98
|
| Rate for Payer: Humana Medicare |
$12,976.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12,721.98
|
| Rate for Payer: United Healthcare Commercial |
$3,190.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,721.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12,721.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10,177.58
|
| Rate for Payer: Wellcare Medicare |
$12,085.88
|
|
|
THROMB+TBA_PERIPH_DIALYSIS_SEG
|
Facility
|
IP
|
$30,010.30
|
|
|
Service Code
|
HCPCS 36905
|
| Hospital Charge Code |
66574709
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$12,721.98
|
|
|
THROMB+TBA_PERIPH_DIALYSIS_SEG
|
Facility
|
OP
|
$30,010.30
|
|
|
Service Code
|
HCPCS 36905
|
| Hospital Charge Code |
66574709
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,477.75 |
| Max. Negotiated Rate |
$22,507.72 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5,593.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12,721.98
|
| Rate for Payer: Aetna Government |
$12,721.98
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8,905.39
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8,905.39
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8,905.39
|
| Rate for Payer: Brighton Health Commercial |
$22,507.72
|
| Rate for Payer: Cash Price |
$12,721.98
|
| Rate for Payer: Cash Price |
$12,721.98
|
| Rate for Payer: Cash Price |
$12,721.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12,721.98
|
| 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 |
$12,721.98
|
| Rate for Payer: EmblemHealth Commercial |
$12,721.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10,813.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11,322.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$12,721.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11,322.56
|
| Rate for Payer: Group Health Inc Commercial |
$12,721.98
|
| Rate for Payer: Group Health Inc Medicare |
$12,721.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15,005.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12,721.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,813.68
|
| Rate for Payer: Healthfirst QHP |
$12,721.98
|
| Rate for Payer: Humana Medicare |
$12,976.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12,721.98
|
| Rate for Payer: United Healthcare Commercial |
$3,190.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12,721.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12,721.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10,177.58
|
| Rate for Payer: Wellcare Medicare |
$12,085.88
|
|
|
THRYOID STIM IMMUNOGLOBULIN
|
Facility
|
IP
|
$127.15
|
|
|
Service Code
|
HCPCS 84445
|
| Hospital Charge Code |
40609124
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$50.86
|
|
|
THRYOID STIM IMMUNOGLOBULIN
|
Facility
|
OP
|
$127.15
|
|
|
Service Code
|
HCPCS 84445
|
| Hospital Charge Code |
40609124
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$35.60 |
| Max. Negotiated Rate |
$95.36 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$69.93
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$50.86
|
| Rate for Payer: Aetna Government |
$50.86
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$35.60
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$35.60
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$35.60
|
| Rate for Payer: Brighton Health Commercial |
$95.36
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$50.86
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$80.82
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$68.39
|
| Rate for Payer: Elderplan Medicare Advantage |
$50.86
|
| Rate for Payer: EmblemHealth Commercial |
$50.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$43.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$45.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$50.86
|
| Rate for Payer: Fidelis Qualified Health Plan |
$45.27
|
| Rate for Payer: Group Health Inc Commercial |
$50.86
|
| Rate for Payer: Group Health Inc Medicare |
$50.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$63.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$50.86
|
| Rate for Payer: Healthfirst Medicare Advantage |
$50.86
|
| Rate for Payer: Healthfirst QHP |
$50.86
|
| Rate for Payer: Humana Medicare |
$51.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$50.86
|
| Rate for Payer: United Healthcare Commercial |
$64.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$50.86
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$50.86
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$40.69
|
| Rate for Payer: Wellcare Medicare |
$45.77
|
|
|
THUMB FCPS 6/15.2CM SERRATED
|
Facility
|
OP
|
$17.38
|
|
| Hospital Charge Code |
64905676
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.08 |
| Max. Negotiated Rate |
$13.90 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$9.56
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8.69
|
| Rate for Payer: Aetna Government |
$8.69
|
| Rate for Payer: Brighton Health Commercial |
$13.04
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.90
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.82
|
| Rate for Payer: Group Health Inc Commercial |
$8.69
|
| Rate for Payer: Group Health Inc Medicare |
$6.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.69
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.69
|
|
|
THUMBWHEEL MICRO LENGTHENER
|
Facility
|
OP
|
$368.88
|
|
| Hospital Charge Code |
64904844
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$129.11 |
| Max. Negotiated Rate |
$295.10 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$202.88
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$184.44
|
| Rate for Payer: Aetna Government |
$184.44
|
| Rate for Payer: Brighton Health Commercial |
$276.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$295.10
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$250.84
|
| Rate for Payer: Group Health Inc Commercial |
$184.44
|
| Rate for Payer: Group Health Inc Medicare |
$129.11
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$184.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$184.44
|
|
|
THUMBWHEEL TELSCPC
|
Facility
|
OP
|
$354.90
|
|
| Hospital Charge Code |
64907407
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$124.22 |
| Max. Negotiated Rate |
$283.92 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$195.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$177.45
|
| Rate for Payer: Aetna Government |
$177.45
|
| Rate for Payer: Brighton Health Commercial |
$266.18
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$283.92
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$241.33
|
| Rate for Payer: Group Health Inc Commercial |
$177.45
|
| Rate for Payer: Group Health Inc Medicare |
$124.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$177.45
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$177.45
|
|
|
THYROGLOBULIN
|
Facility
|
OP
|
$552.45
|
|
| Hospital Charge Code |
64902740
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$193.36 |
| Max. Negotiated Rate |
$441.96 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$303.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$276.22
|
| Rate for Payer: Aetna Government |
$276.22
|
| Rate for Payer: Brighton Health Commercial |
$414.34
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$441.96
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$375.67
|
| Rate for Payer: Group Health Inc Commercial |
$276.22
|
| Rate for Payer: Group Health Inc Medicare |
$193.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$276.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$276.22
|
|
|
THYROGLOBULIN ANTIBODY
|
Facility
|
IP
|
$39.78
|
|
|
Service Code
|
HCPCS 86800
|
| Hospital Charge Code |
40609150
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$15.91
|
|
|
THYROGLOBULIN ANTIBODY
|
Facility
|
OP
|
$39.78
|
|
|
Service Code
|
HCPCS 86800
|
| Hospital Charge Code |
40609150
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.14 |
| Max. Negotiated Rate |
$29.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$21.88
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.91
|
| Rate for Payer: Aetna Government |
$15.91
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$11.14
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$11.14
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$11.14
|
| Rate for Payer: Brighton Health Commercial |
$29.84
|
| Rate for Payer: Cash Price |
$15.91
|
| Rate for Payer: Cash Price |
$15.91
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15.91
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$25.28
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$21.40
|
| Rate for Payer: Elderplan Medicare Advantage |
$15.91
|
| Rate for Payer: EmblemHealth Commercial |
$15.91
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$13.52
|
| Rate for Payer: Fidelis Essential Plan QHP |
$14.16
|
| Rate for Payer: Fidelis Medicare Advantage |
$15.91
|
| Rate for Payer: Fidelis Qualified Health Plan |
$14.16
|
| Rate for Payer: Group Health Inc Commercial |
$15.91
|
| Rate for Payer: Group Health Inc Medicare |
$15.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.91
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.91
|
| Rate for Payer: Healthfirst QHP |
$15.91
|
| Rate for Payer: Humana Medicare |
$16.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15.91
|
| Rate for Payer: United Healthcare Commercial |
$20.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15.91
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.73
|
| Rate for Payer: Wellcare Medicare |
$14.32
|
|
|
THYROGLOBULIN & ATA
|
Facility
|
IP
|
$39.78
|
|
|
Service Code
|
HCPCS 86800
|
| Hospital Charge Code |
40608039
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$15.91
|
|
|
THYROGLOBULIN & ATA
|
Facility
|
OP
|
$39.78
|
|
|
Service Code
|
HCPCS 86800
|
| Hospital Charge Code |
40608039
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.14 |
| Max. Negotiated Rate |
$29.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$21.88
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.91
|
| Rate for Payer: Aetna Government |
$15.91
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$11.14
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$11.14
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$11.14
|
| Rate for Payer: Brighton Health Commercial |
$29.84
|
| Rate for Payer: Cash Price |
$15.91
|
| Rate for Payer: Cash Price |
$15.91
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15.91
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$25.28
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$21.40
|
| Rate for Payer: Elderplan Medicare Advantage |
$15.91
|
| Rate for Payer: EmblemHealth Commercial |
$15.91
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$13.52
|
| Rate for Payer: Fidelis Essential Plan QHP |
$14.16
|
| Rate for Payer: Fidelis Medicare Advantage |
$15.91
|
| Rate for Payer: Fidelis Qualified Health Plan |
$14.16
|
| Rate for Payer: Group Health Inc Commercial |
$15.91
|
| Rate for Payer: Group Health Inc Medicare |
$15.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.91
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.91
|
| Rate for Payer: Healthfirst QHP |
$15.91
|
| Rate for Payer: Humana Medicare |
$16.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15.91
|
| Rate for Payer: United Healthcare Commercial |
$20.14
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15.91
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.73
|
| Rate for Payer: Wellcare Medicare |
$14.32
|
|
|
THYROID 15 MG PO TABS [7940]
|
Facility
|
OP
|
$0.98
|
|
|
Service Code
|
NDC 00456045701
|
| Hospital Charge Code |
00456045701
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$0.79 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.54
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.49
|
| Rate for Payer: Aetna Government |
$0.49
|
| Rate for Payer: Brighton Health Commercial |
$0.74
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.79
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.67
|
| Rate for Payer: Group Health Inc Commercial |
$0.49
|
| Rate for Payer: Group Health Inc Medicare |
$0.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.64
|
|
|
THYROID 15MG TAB
|
Facility
|
OP
|
$0.19
|
|
| Hospital Charge Code |
41648412
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.15 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.10
|
| Rate for Payer: Aetna Government |
$0.10
|
| Rate for Payer: Brighton Health Commercial |
$0.14
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.13
|
| Rate for Payer: Group Health Inc Commercial |
$0.10
|
| Rate for Payer: Group Health Inc Medicare |
$0.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.10
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.12
|
|
|
THYROID 15MG TAB
|
Facility
|
OP
|
$0.19
|
|
| Hospital Charge Code |
41658412
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.15 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.10
|
| Rate for Payer: Aetna Government |
$0.10
|
| Rate for Payer: Brighton Health Commercial |
$0.14
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.13
|
| Rate for Payer: Group Health Inc Commercial |
$0.10
|
| Rate for Payer: Group Health Inc Medicare |
$0.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.10
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.12
|
|
|
THYROID ANTIBODIES
|
Facility
|
IP
|
$36.38
|
|
|
Service Code
|
HCPCS 86376
|
| Hospital Charge Code |
40729346
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$14.55
|
|
|
THYROID ANTIBODIES
|
Facility
|
OP
|
$36.38
|
|
|
Service Code
|
HCPCS 86376
|
| Hospital Charge Code |
40729346
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.18 |
| Max. Negotiated Rate |
$27.28 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$20.01
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$14.55
|
| Rate for Payer: Aetna Government |
$14.55
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$10.18
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$10.18
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10.18
|
| Rate for Payer: Brighton Health Commercial |
$27.28
|
| Rate for Payer: Cash Price |
$14.55
|
| Rate for Payer: Cash Price |
$14.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$14.55
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$23.13
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$19.57
|
| Rate for Payer: Elderplan Medicare Advantage |
$14.55
|
| Rate for Payer: EmblemHealth Commercial |
$14.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$12.95
|
| Rate for Payer: Fidelis Medicare Advantage |
$14.55
|
| Rate for Payer: Fidelis Qualified Health Plan |
$12.95
|
| Rate for Payer: Group Health Inc Commercial |
$14.55
|
| Rate for Payer: Group Health Inc Medicare |
$14.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.55
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14.55
|
| Rate for Payer: Healthfirst QHP |
$14.55
|
| Rate for Payer: Humana Medicare |
$14.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$14.55
|
| Rate for Payer: United Healthcare Commercial |
$18.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$14.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$14.55
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$11.64
|
| Rate for Payer: Wellcare Medicare |
$13.10
|
|
|
THYROID CA/METS WHOLE BODY
|
Facility
|
OP
|
$1,429.50
|
|
|
Service Code
|
HCPCS 78018 TC
|
| Hospital Charge Code |
41505012
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$232.09 |
| Max. Negotiated Rate |
$786.22 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$786.22
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$625.05
|
| Rate for Payer: Aetna Government |
$625.05
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$437.54
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$437.54
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$437.54
|
| Rate for Payer: Brighton Health Commercial |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Cash Price |
$625.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$625.05
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$580.64
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$491.32
|
| Rate for Payer: Elderplan Medicare Advantage |
$625.05
|
| Rate for Payer: EmblemHealth Commercial |
$437.54
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$531.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$531.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$556.29
|
| Rate for Payer: Fidelis Medicare Advantage |
$625.05
|
| Rate for Payer: Fidelis Qualified Health Plan |
$556.29
|
| Rate for Payer: Group Health Inc Commercial |
$562.54
|
| Rate for Payer: Group Health Inc Medicare |
$562.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$714.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$625.05
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$562.54
|
| Rate for Payer: Healthfirst Medicare Advantage |
$625.05
|
| Rate for Payer: Healthfirst QHP |
$625.05
|
| Rate for Payer: Humana Medicare |
$637.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$625.05
|
| Rate for Payer: United Healthcare Commercial |
$232.09
|
| Rate for Payer: United Healthcare Medicare Advantage |
$625.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$625.05
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$500.04
|
| Rate for Payer: Wellcare Medicare |
$593.80
|
|
|
THYROID CA/METS WHOLE BODY
|
Facility
|
IP
|
$1,429.50
|
|
|
Service Code
|
HCPCS 78018 TC
|
| Hospital Charge Code |
41505012
|
|
Hospital Revenue Code
|
340
|
| Rate for Payer: Cash Price |
$625.05
|
|
|
THYROIDECTOMY
|
Facility
|
IP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 60240
|
| Hospital Charge Code |
40109229
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,672.53
|
|
|
THYROIDECTOMY
|
Facility
|
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 60240
|
| Hospital Charge Code |
40109229
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$10,980.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,670.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,670.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,670.77
|
| Rate for Payer: Brighton Health Commercial |
$10,980.08
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Humana Medicare |
$6,805.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
|
THYROIDECTOMY - ISTHMUSECTOMY
|
Facility
|
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 60210
|
| Hospital Charge Code |
40019582
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$10,980.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,670.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,670.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,670.77
|
| Rate for Payer: Brighton Health Commercial |
$10,980.08
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Humana Medicare |
$6,805.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
