|
VASCULAR STUDY, COMPLETE
|
Facility
|
OP
|
$705.83
|
|
|
Service Code
|
HCPCS 93975 TC
|
| Hospital Charge Code |
41301527
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$247.04 |
| Max. Negotiated Rate |
$564.66 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$388.21
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$352.92
|
| Rate for Payer: Aetna Government |
$352.92
|
| Rate for Payer: Brighton Health Commercial |
$529.37
|
| Rate for Payer: Cash Price |
$283.37
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$564.66
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$479.96
|
| Rate for Payer: Group Health Inc Commercial |
$352.92
|
| Rate for Payer: Group Health Inc Medicare |
$247.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$352.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$352.92
|
|
|
VASCULAR STUDY, LIMITED
|
Facility
|
OP
|
$339.45
|
|
|
Service Code
|
HCPCS 93976 TC
|
| Hospital Charge Code |
41301528
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$118.81 |
| Max. Negotiated Rate |
$271.56 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$186.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$169.72
|
| Rate for Payer: Aetna Government |
$169.72
|
| Rate for Payer: Brighton Health Commercial |
$254.59
|
| Rate for Payer: Cash Price |
$127.14
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$271.56
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$230.83
|
| Rate for Payer: Group Health Inc Commercial |
$169.72
|
| Rate for Payer: Group Health Inc Medicare |
$118.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$169.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$169.72
|
|
|
VASCULAR STUDY, LIMITED
|
Facility
|
IP
|
$339.45
|
|
|
Service Code
|
HCPCS 93976 TC
|
| Hospital Charge Code |
41301528
|
|
Hospital Revenue Code
|
921
|
| Rate for Payer: Cash Price |
$127.14
|
|
|
VASCULAR STUDY TCP02
|
Facility
|
OP
|
$330.23
|
|
|
Service Code
|
HCPCS 93922 TC
|
| Hospital Charge Code |
42500113
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$115.58 |
| Max. Negotiated Rate |
$264.18 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$181.63
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$165.12
|
| Rate for Payer: Aetna Government |
$165.12
|
| Rate for Payer: Brighton Health Commercial |
$247.67
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$264.18
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$224.56
|
| Rate for Payer: Group Health Inc Commercial |
$165.12
|
| Rate for Payer: Group Health Inc Medicare |
$115.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$165.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$165.12
|
|
|
VASCULAR STUDY TCP02
|
Facility
|
IP
|
$330.23
|
|
|
Service Code
|
HCPCS 93922 TC
|
| Hospital Charge Code |
42500113
|
|
Hospital Revenue Code
|
920
|
| Rate for Payer: Cash Price |
$147.72
|
|
|
VASECTOMY
|
Facility
|
OP
|
$5,365.58
|
|
|
Service Code
|
HCPCS 55250
|
| Hospital Charge Code |
40123095
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$208,457.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,355.42
|
| Rate for Payer: Aetna Government |
$2,355.42
|
| Rate for Payer: Amida Care Medicaid |
$2,084.57
|
| Rate for Payer: Brighton Health Commercial |
$4,024.18
|
| Rate for Payer: Cash Price |
$2,355.42
|
| Rate for Payer: Cash Price |
$2,355.42
|
| Rate for Payer: Cash Price |
$2,355.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,355.42
|
| 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 |
$2,355.42
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$208,457.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,084.57
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,084.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,355.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,188.80
|
| Rate for Payer: Group Health Inc Commercial |
$2,355.42
|
| Rate for Payer: Group Health Inc Medicare |
$2,355.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,084.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,355.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,084.57
|
| Rate for Payer: Healthfirst Essential Plan |
$4,690.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,002.11
|
| Rate for Payer: Healthfirst QHP |
$2,084.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,355.42
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,084.57
|
| Rate for Payer: SOMOS Essential |
$4,690.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,355.42
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,884.34
|
| Rate for Payer: Wellcare Medicare |
$2,237.65
|
|
|
VASECTOMY
|
Facility
|
IP
|
$5,365.58
|
|
|
Service Code
|
HCPCS 55250
|
| Hospital Charge Code |
40123095
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$2,355.42
|
|
|
Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s)
|
Facility
|
OP
|
$208,457.00
|
|
|
Service Code
|
CPT 55250
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$208,457.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,355.42
|
| Rate for Payer: Aetna Government |
$2,355.42
|
| Rate for Payer: Amida Care Medicaid |
$2,084.57
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,355.42
|
| 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 |
$2,355.42
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$208,457.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,084.57
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,084.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,355.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,188.80
|
| Rate for Payer: Group Health Inc Commercial |
$2,355.42
|
| Rate for Payer: Group Health Inc Medicare |
$2,355.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,084.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,355.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,084.57
|
| Rate for Payer: Healthfirst Essential Plan |
$4,690.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,002.11
|
| Rate for Payer: Healthfirst QHP |
$2,084.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,355.42
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,084.57
|
| Rate for Payer: SOMOS Essential |
$4,690.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,355.42
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,884.34
|
| Rate for Payer: Wellcare Medicare |
$2,237.65
|
|
|
VASELINE GAUZE
|
Facility
|
OP
|
$6.73
|
|
| Hospital Charge Code |
40206615
|
|
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: Brighton Health Commercial |
$5.05
|
| 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
|
|
|
VAS GRAFT R06020080L
|
Facility
|
OP
|
$1,652.45
|
|
| Hospital Charge Code |
40207022
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$578.36 |
| Max. Negotiated Rate |
$1,321.96 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$908.85
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$826.22
|
| Rate for Payer: Aetna Government |
$826.22
|
| Rate for Payer: Brighton Health Commercial |
$1,239.34
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,321.96
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,123.67
|
| Rate for Payer: Group Health Inc Commercial |
$826.22
|
| Rate for Payer: Group Health Inc Medicare |
$578.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$826.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$826.22
|
|
|
VAS GRAFT RR47010045L
|
Facility
|
OP
|
$1,293.82
|
|
| Hospital Charge Code |
40207019
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$452.84 |
| Max. Negotiated Rate |
$1,035.06 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$711.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$646.91
|
| Rate for Payer: Aetna Government |
$646.91
|
| Rate for Payer: Brighton Health Commercial |
$970.36
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,035.06
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$879.80
|
| Rate for Payer: Group Health Inc Commercial |
$646.91
|
| Rate for Payer: Group Health Inc Medicare |
$452.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$646.91
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$646.91
|
|
|
VAS GRAFT RRT06060080L
|
Facility
|
OP
|
$2,241.42
|
|
| Hospital Charge Code |
40207021
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$784.50 |
| Max. Negotiated Rate |
$1,793.14 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,232.78
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,120.71
|
| Rate for Payer: Aetna Government |
$1,120.71
|
| Rate for Payer: Brighton Health Commercial |
$1,681.06
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,793.14
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,524.17
|
| Rate for Payer: Group Health Inc Commercial |
$1,120.71
|
| Rate for Payer: Group Health Inc Medicare |
$784.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,120.71
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,120.71
|
|
|
VASOPRESSIN 20 UNIT/ML IV SOLN [127636]
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
00517102025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$39.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$33.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.82
|
| Rate for Payer: Aetna Government |
$1.82
|
| Rate for Payer: Brighton Health Commercial |
$36.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$30.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$34.50
|
| Rate for Payer: Elderplan Medicare Advantage |
$1.82
|
| Rate for Payer: EmblemHealth Commercial |
$30.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$1.82
|
| Rate for Payer: Group Health Inc Commercial |
$1.82
|
| Rate for Payer: Group Health Inc Medicare |
$1.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1.54
|
| Rate for Payer: Healthfirst QHP |
$1.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$39.00
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1.45
|
|
|
VASOPRESSIN 20 UNIT/ML IV SOLN [127636]
|
Facility
|
IP
|
$126.13
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
70121164205
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.06 |
| Max. Negotiated Rate |
$63.06 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$63.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$63.06
|
|
|
VASOPRESSIN 20 UNIT/ML IV SOLN [127636]
|
Facility
|
OP
|
$97.20
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
42023016425
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$63.18 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$53.46
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.82
|
| Rate for Payer: Aetna Government |
$1.82
|
| Rate for Payer: Brighton Health Commercial |
$58.32
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$48.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$55.89
|
| Rate for Payer: Elderplan Medicare Advantage |
$1.82
|
| Rate for Payer: EmblemHealth Commercial |
$48.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$1.82
|
| Rate for Payer: Group Health Inc Commercial |
$1.82
|
| Rate for Payer: Group Health Inc Medicare |
$1.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$48.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$48.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1.54
|
| Rate for Payer: Healthfirst QHP |
$1.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$63.18
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1.45
|
|
|
VASOPRESSIN 20 UNIT/ML IV SOLN [127636]
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
00517102025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.00
|
|
|
VASOPRESSIN 20 UNIT/ML IV SOLN [127636]
|
Facility
|
IP
|
$180.18
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
55150037125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$90.09 |
| Max. Negotiated Rate |
$90.09 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$90.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$90.09
|
|
|
VASOPRESSIN 20 UNIT/ML IV SOLN [127636]
|
Facility
|
IP
|
$189.66
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
42367057087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$94.83 |
| Max. Negotiated Rate |
$94.83 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$94.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$94.83
|
|
|
VASOPRESSIN 20 UNIT/ML IV SOLN [127636]
|
Facility
|
OP
|
$189.66
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
42367057087
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$123.28 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$104.31
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.82
|
| Rate for Payer: Aetna Government |
$1.82
|
| Rate for Payer: Brighton Health Commercial |
$113.79
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$94.83
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$109.05
|
| Rate for Payer: Elderplan Medicare Advantage |
$1.82
|
| Rate for Payer: EmblemHealth Commercial |
$94.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$1.82
|
| Rate for Payer: Group Health Inc Commercial |
$1.82
|
| Rate for Payer: Group Health Inc Medicare |
$1.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$94.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$94.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1.54
|
| Rate for Payer: Healthfirst QHP |
$1.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$123.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1.45
|
|
|
VASOPRESSIN 20 UNIT/ML IV SOLN [127636]
|
Facility
|
OP
|
$180.18
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
55150037125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$117.11 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$99.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.82
|
| Rate for Payer: Aetna Government |
$1.82
|
| Rate for Payer: Brighton Health Commercial |
$108.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$90.09
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$103.60
|
| Rate for Payer: Elderplan Medicare Advantage |
$1.82
|
| Rate for Payer: EmblemHealth Commercial |
$90.09
|
| Rate for Payer: Fidelis Medicare Advantage |
$1.82
|
| Rate for Payer: Group Health Inc Commercial |
$1.82
|
| Rate for Payer: Group Health Inc Medicare |
$1.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$90.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$90.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1.54
|
| Rate for Payer: Healthfirst QHP |
$1.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$117.11
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1.45
|
|
|
VASOPRESSIN 20 UNIT/ML IV SOLN [127636]
|
Facility
|
IP
|
$60.00
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
00548970100
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.00
|
|
|
VASOPRESSIN 20 UNIT/ML IV SOLN [127636]
|
Facility
|
OP
|
$60.00
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
00548970100
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$39.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$33.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.82
|
| Rate for Payer: Aetna Government |
$1.82
|
| Rate for Payer: Brighton Health Commercial |
$36.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$30.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$34.50
|
| Rate for Payer: Elderplan Medicare Advantage |
$1.82
|
| Rate for Payer: EmblemHealth Commercial |
$30.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$1.82
|
| Rate for Payer: Group Health Inc Commercial |
$1.82
|
| Rate for Payer: Group Health Inc Medicare |
$1.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1.54
|
| Rate for Payer: Healthfirst QHP |
$1.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$39.00
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1.45
|
|
|
VASOPRESSIN 20 UNIT/ML IV SOLN [127636]
|
Facility
|
IP
|
$97.20
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
42023016425
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$48.60 |
| Max. Negotiated Rate |
$48.60 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$48.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$48.60
|
|
|
VASOPRESSIN 20 UNIT/ML IV SOLN [127636]
|
Facility
|
OP
|
$126.13
|
|
|
Service Code
|
HCPCS J2598
|
| Hospital Charge Code |
70121164205
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$81.98 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$69.37
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.82
|
| Rate for Payer: Aetna Government |
$1.82
|
| Rate for Payer: Brighton Health Commercial |
$75.68
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$63.06
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$72.52
|
| Rate for Payer: Elderplan Medicare Advantage |
$1.82
|
| Rate for Payer: EmblemHealth Commercial |
$63.06
|
| Rate for Payer: Fidelis Medicare Advantage |
$1.82
|
| Rate for Payer: Group Health Inc Commercial |
$1.82
|
| Rate for Payer: Group Health Inc Medicare |
$1.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$63.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$63.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1.54
|
| Rate for Payer: Healthfirst QHP |
$1.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$81.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1.45
|
|
|
VASOPRESSIN 20 UNITS/ML INJ
|
Facility
|
OP
|
$9.00
|
|
| Hospital Charge Code |
41653641
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$7.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.50
|
| Rate for Payer: Aetna Government |
$4.50
|
| Rate for Payer: Brighton Health Commercial |
$6.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$7.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.12
|
| Rate for Payer: Group Health Inc Commercial |
$4.50
|
| Rate for Payer: Group Health Inc Medicare |
$3.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.85
|
|
