|
CARBOPLATIN 10 MG/ML INJ 45 ML
|
Facility
IP
|
$6.24
|
|
|
Service Code
|
HCPCS J9045
|
| Hospital Charge Code |
41654417
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$3.12 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.12
|
|
|
CARBOPLATIN 10 MG/ML INJ 5 ML
|
Facility
IP
|
$6.78
|
|
|
Service Code
|
HCPCS J9045
|
| Hospital Charge Code |
41653724
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$3.39 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.39
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.39
|
|
|
CARBOPLATIN 10 MG/ML INJ 5 ML
|
Facility
IP
|
$6.78
|
|
|
Service Code
|
HCPCS J9045
|
| Hospital Charge Code |
41643724
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$3.39 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.39
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.39
|
|
|
CARBOPLATIN 10 MG/ML INJ 5 ML
|
Facility
OP
|
$6.78
|
|
|
Service Code
|
HCPCS J9045
|
| Hospital Charge Code |
41643724
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.17 |
| Max. Negotiated Rate |
$4.41 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.73
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2.64
|
| Rate for Payer: Aetna Government |
$2.64
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.39
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$3.90
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2.17
|
| Rate for Payer: Group Health Inc Commercial |
$3.39
|
| Rate for Payer: Group Health Inc Medicare |
$2.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.39
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2.41
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3.95
|
| Rate for Payer: SOMOS Essential |
$3.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.41
|
|
|
CARBOPLATIN 10 MG/ML INJ 5 ML
|
Facility
OP
|
$6.78
|
|
|
Service Code
|
HCPCS J9045
|
| Hospital Charge Code |
41653724
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.17 |
| Max. Negotiated Rate |
$4.41 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.73
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2.64
|
| Rate for Payer: Aetna Government |
$2.64
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.39
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$3.90
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2.17
|
| Rate for Payer: Group Health Inc Commercial |
$3.39
|
| Rate for Payer: Group Health Inc Medicare |
$2.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.39
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2.41
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3.95
|
| Rate for Payer: SOMOS Essential |
$3.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.41
|
|
|
CARBOPROST 250 MCG/ML INJ
|
Facility
OP
|
$220.53
|
|
| Hospital Charge Code |
41641437
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$77.19 |
| Max. Negotiated Rate |
$176.42 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$121.29
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$110.26
|
| Rate for Payer: Aetna Government |
$110.26
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$176.42
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$149.96
|
| Rate for Payer: Group Health Inc Commercial |
$110.26
|
| Rate for Payer: Group Health Inc Medicare |
$77.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$110.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$110.26
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$143.34
|
|
|
CARBOPROST 250 MCG/ML INJ
|
Facility
OP
|
$220.53
|
|
| Hospital Charge Code |
41651437
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$77.19 |
| Max. Negotiated Rate |
$176.42 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$121.29
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$110.26
|
| Rate for Payer: Aetna Government |
$110.26
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$176.42
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$149.96
|
| Rate for Payer: Group Health Inc Commercial |
$110.26
|
| Rate for Payer: Group Health Inc Medicare |
$77.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$110.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$110.26
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$143.34
|
|
|
CARBOXY HEMOGLOBIN
|
Facility
OP
|
$30.80
|
|
|
Service Code
|
HCPCS 82375
|
| Hospital Charge Code |
40602055
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$19.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$16.94
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.32
|
| Rate for Payer: Aetna Government |
$12.32
|
| Rate for Payer: Cash Price |
$12.32
|
| Rate for Payer: Cash Price |
$12.32
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12.32
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$19.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$16.59
|
| Rate for Payer: Elderplan Medicare Advantage |
$12.32
|
| Rate for Payer: EmblemHealth Commercial |
$12.32
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$11.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10.47
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$12.32
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.96
|
| Rate for Payer: Group Health Inc Commercial |
$12.32
|
| Rate for Payer: Group Health Inc Medicare |
$12.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.32
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12.32
|
| Rate for Payer: Healthfirst QHP |
$12.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12.32
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12.32
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9.86
|
| Rate for Payer: Wellcare Medicare |
$11.09
|
|
|
CARDIAC ARREST, UNEXPLAINED WITH CC
|
Facility
IP
|
$17,780.27
|
|
|
Service Code
|
MS-DRG 297
|
| Min. Negotiated Rate |
$6,247.75 |
| Max. Negotiated Rate |
$17,780.27 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$10,743.21
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17,431.64
|
| Rate for Payer: Aetna Government |
$17,431.64
|
| Rate for Payer: Brighton Health Commercial |
$10,564.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$17,780.27
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$12,582.19
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$10,383.37
|
| Rate for Payer: Elderplan Medicare Advantage |
$16,560.06
|
| Rate for Payer: EmblemHealth Commercial |
$6,247.75
|
| Rate for Payer: Fidelis Medicare Advantage |
$17,431.64
|
| Rate for Payer: Group Health Inc Commercial |
$17,431.64
|
| Rate for Payer: Group Health Inc Medicare |
$17,431.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17,431.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8,105.71
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17,431.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17,431.64
|
| Rate for Payer: Wellcare Medicare |
$16,560.06
|
|
|
CARDIAC ARREST, UNEXPLAINED WITH MCC
|
Facility
IP
|
$30,151.23
|
|
|
Service Code
|
MS-DRG 296
|
| Min. Negotiated Rate |
$13,745.41 |
| Max. Negotiated Rate |
$30,151.23 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$23,639.18
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$29,560.03
|
| Rate for Payer: Aetna Government |
$29,560.03
|
| Rate for Payer: Brighton Health Commercial |
$23,246.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$30,151.23
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$27,685.66
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$22,847.40
|
| Rate for Payer: Elderplan Medicare Advantage |
$28,082.03
|
| Rate for Payer: EmblemHealth Commercial |
$13,747.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$29,560.03
|
| Rate for Payer: Group Health Inc Commercial |
$29,560.03
|
| Rate for Payer: Group Health Inc Medicare |
$29,560.03
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$29,560.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13,745.41
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$29,560.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$29,560.03
|
| Rate for Payer: Wellcare Medicare |
$28,082.03
|
|
|
CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC
|
Facility
IP
|
$13,693.84
|
|
|
Service Code
|
MS-DRG 298
|
| Min. Negotiated Rate |
$3,763.57 |
| Max. Negotiated Rate |
$13,693.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$6,471.58
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$13,425.33
|
| Rate for Payer: Aetna Government |
$13,425.33
|
| Rate for Payer: Brighton Health Commercial |
$6,364.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$13,693.84
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$7,593.18
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6,266.22
|
| Rate for Payer: Elderplan Medicare Advantage |
$12,754.06
|
| Rate for Payer: EmblemHealth Commercial |
$3,763.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$13,425.33
|
| Rate for Payer: Group Health Inc Commercial |
$13,425.33
|
| Rate for Payer: Group Health Inc Medicare |
$13,425.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$13,425.33
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6,242.78
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$13,425.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$13,425.33
|
| Rate for Payer: Wellcare Medicare |
$12,754.06
|
|
|
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC
|
Facility
IP
|
$18,007.97
|
|
|
Service Code
|
MS-DRG 309
|
| Min. Negotiated Rate |
$6,385.80 |
| Max. Negotiated Rate |
$18,007.97 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$10,980.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17,654.87
|
| Rate for Payer: Aetna Government |
$17,654.87
|
| Rate for Payer: Brighton Health Commercial |
$10,798.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$18,007.97
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$12,860.22
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$10,612.81
|
| Rate for Payer: Elderplan Medicare Advantage |
$16,772.13
|
| Rate for Payer: EmblemHealth Commercial |
$6,385.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$17,654.87
|
| Rate for Payer: Group Health Inc Commercial |
$17,654.87
|
| Rate for Payer: Group Health Inc Medicare |
$17,654.87
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17,654.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8,209.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17,654.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17,654.87
|
| Rate for Payer: Wellcare Medicare |
$16,772.13
|
|
|
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC
|
Facility
IP
|
$24,479.19
|
|
|
Service Code
|
MS-DRG 308
|
| Min. Negotiated Rate |
$10,308.90 |
| Max. Negotiated Rate |
$24,479.19 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17,726.44
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$23,999.21
|
| Rate for Payer: Aetna Government |
$23,999.21
|
| Rate for Payer: Brighton Health Commercial |
$17,431.90
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$24,479.19
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20,760.79
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17,132.70
|
| Rate for Payer: Elderplan Medicare Advantage |
$22,799.25
|
| Rate for Payer: EmblemHealth Commercial |
$10,308.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$23,999.21
|
| Rate for Payer: Group Health Inc Commercial |
$23,999.21
|
| Rate for Payer: Group Health Inc Medicare |
$23,999.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$23,999.21
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11,159.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$23,999.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$23,999.21
|
| Rate for Payer: Wellcare Medicare |
$22,799.25
|
|
|
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC
|
Facility
IP
|
$15,296.44
|
|
|
Service Code
|
MS-DRG 310
|
| Min. Negotiated Rate |
$4,741.98 |
| Max. Negotiated Rate |
$15,296.44 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8,153.99
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$14,996.51
|
| Rate for Payer: Aetna Government |
$14,996.51
|
| Rate for Payer: Brighton Health Commercial |
$8,018.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15,296.44
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$9,549.76
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7,880.87
|
| Rate for Payer: Elderplan Medicare Advantage |
$14,246.68
|
| Rate for Payer: EmblemHealth Commercial |
$4,741.98
|
| Rate for Payer: Fidelis Medicare Advantage |
$14,996.51
|
| Rate for Payer: Group Health Inc Commercial |
$14,996.51
|
| Rate for Payer: Group Health Inc Medicare |
$14,996.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14,996.51
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6,973.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$14,996.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$14,996.51
|
| Rate for Payer: Wellcare Medicare |
$14,246.68
|
|
|
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC
|
Facility
IP
|
$29,212.02
|
|
|
Service Code
|
MS-DRG 306
|
| Min. Negotiated Rate |
$13,178.10 |
| Max. Negotiated Rate |
$29,212.02 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$22,660.12
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$28,639.24
|
| Rate for Payer: Aetna Government |
$28,639.24
|
| Rate for Payer: Brighton Health Commercial |
$22,283.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$29,212.02
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$26,539.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$21,901.12
|
| Rate for Payer: Elderplan Medicare Advantage |
$27,207.28
|
| Rate for Payer: EmblemHealth Commercial |
$13,178.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$28,639.24
|
| Rate for Payer: Group Health Inc Commercial |
$28,639.24
|
| Rate for Payer: Group Health Inc Medicare |
$28,639.24
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$28,639.24
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13,317.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$28,639.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$28,639.24
|
| Rate for Payer: Wellcare Medicare |
$27,207.28
|
|
|
CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC
|
Facility
IP
|
$20,807.21
|
|
|
Service Code
|
MS-DRG 307
|
| Min. Negotiated Rate |
$8,082.80 |
| Max. Negotiated Rate |
$20,807.21 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13,898.64
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$20,399.23
|
| Rate for Payer: Aetna Government |
$20,399.23
|
| Rate for Payer: Brighton Health Commercial |
$13,667.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$20,807.21
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$16,277.76
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$13,433.11
|
| Rate for Payer: Elderplan Medicare Advantage |
$19,379.27
|
| Rate for Payer: EmblemHealth Commercial |
$8,082.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$20,399.23
|
| Rate for Payer: Group Health Inc Commercial |
$20,399.23
|
| Rate for Payer: Group Health Inc Medicare |
$20,399.23
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$20,399.23
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9,485.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$20,399.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$20,399.23
|
| Rate for Payer: Wellcare Medicare |
$19,379.27
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC
|
Facility
IP
|
$121,501.23
|
|
|
Service Code
|
MS-DRG 275
|
| Min. Negotiated Rate |
$48,776.63 |
| Max. Negotiated Rate |
$121,501.23 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$103,742.87
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$104,895.98
|
| Rate for Payer: Aetna Government |
$104,895.98
|
| Rate for Payer: Brighton Health Commercial |
$102,019.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$106,993.90
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$121,501.23
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$100,268.03
|
| Rate for Payer: Elderplan Medicare Advantage |
$99,651.18
|
| Rate for Payer: EmblemHealth Commercial |
$60,332.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$104,895.98
|
| Rate for Payer: Group Health Inc Commercial |
$104,895.98
|
| Rate for Payer: Group Health Inc Medicare |
$104,895.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$104,895.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$48,776.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$104,895.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$104,895.98
|
| Rate for Payer: Wellcare Medicare |
$99,651.18
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITH MCC
|
Facility
IP
|
$107,243.94
|
|
|
Service Code
|
MS-DRG 276
|
| Min. Negotiated Rate |
$43,452.89 |
| Max. Negotiated Rate |
$107,243.94 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$91,569.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$93,447.08
|
| Rate for Payer: Aetna Government |
$93,447.08
|
| Rate for Payer: Brighton Health Commercial |
$90,047.90
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$95,316.02
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$107,243.94
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$88,502.31
|
| Rate for Payer: Elderplan Medicare Advantage |
$88,774.73
|
| Rate for Payer: EmblemHealth Commercial |
$53,252.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$93,447.08
|
| Rate for Payer: Group Health Inc Commercial |
$93,447.08
|
| Rate for Payer: Group Health Inc Medicare |
$93,447.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$93,447.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$43,452.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$93,447.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$93,447.08
|
| Rate for Payer: Wellcare Medicare |
$88,774.73
|
|
|
CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC
|
Facility
IP
|
$82,587.27
|
|
|
Service Code
|
MS-DRG 277
|
| Min. Negotiated Rate |
$34,245.95 |
| Max. Negotiated Rate |
$82,587.27 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$70,516.49
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$73,647.21
|
| Rate for Payer: Aetna Government |
$73,647.21
|
| Rate for Payer: Brighton Health Commercial |
$69,344.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$75,120.15
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$82,587.27
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$68,154.56
|
| Rate for Payer: Elderplan Medicare Advantage |
$69,964.85
|
| Rate for Payer: EmblemHealth Commercial |
$41,009.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$73,647.21
|
| Rate for Payer: Group Health Inc Commercial |
$73,647.21
|
| Rate for Payer: Group Health Inc Medicare |
$73,647.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$73,647.21
|
| Rate for Payer: Healthfirst Medicare Advantage |
$34,245.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$73,647.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$73,647.21
|
| Rate for Payer: Wellcare Medicare |
$69,964.85
|
|
|
CARDIAC LINQ 2 SYSTEM MED
|
Facility
OP
|
$13,232.50
|
|
|
Service Code
|
HCPCS C1764
|
| Hospital Charge Code |
66571447
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,126.13 |
| Max. Negotiated Rate |
$13,894.12 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7,277.88
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,126.13
|
| Rate for Payer: Aetna Government |
$4,126.13
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6,616.25
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7,608.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$13,894.12
|
| Rate for Payer: Group Health Inc Commercial |
$6,616.25
|
| Rate for Payer: Group Health Inc Medicare |
$4,631.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6,616.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,616.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8,601.12
|
|
|
CARDIAC LINQ 2 SYSTEM MED
|
Facility
IP
|
$13,232.50
|
|
|
Service Code
|
HCPCS C1764
|
| Hospital Charge Code |
66571447
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,616.25 |
| Max. Negotiated Rate |
$6,616.25 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6,616.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,616.25
|
|
|
CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC
|
Facility
IP
|
$46,774.81
|
|
|
Service Code
|
MS-DRG 258
|
| Min. Negotiated Rate |
$20,873.40 |
| Max. Negotiated Rate |
$46,774.81 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$39,938.31
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$44,889.04
|
| Rate for Payer: Aetna Government |
$44,889.04
|
| Rate for Payer: Brighton Health Commercial |
$39,274.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$45,786.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$46,774.81
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$38,600.58
|
| Rate for Payer: Elderplan Medicare Advantage |
$42,644.59
|
| Rate for Payer: EmblemHealth Commercial |
$23,226.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$44,889.04
|
| Rate for Payer: Group Health Inc Commercial |
$44,889.04
|
| Rate for Payer: Group Health Inc Medicare |
$44,889.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$44,889.04
|
| Rate for Payer: Healthfirst Medicare Advantage |
$20,873.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$44,889.04
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$44,889.04
|
| Rate for Payer: Wellcare Medicare |
$42,644.59
|
|
|
CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC
|
Facility
IP
|
$33,876.95
|
|
|
Service Code
|
MS-DRG 259
|
| Min. Negotiated Rate |
$15,443.91 |
| Max. Negotiated Rate |
$33,876.95 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$27,523.02
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$33,212.70
|
| Rate for Payer: Aetna Government |
$33,212.70
|
| Rate for Payer: Brighton Health Commercial |
$27,065.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$33,876.95
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$32,234.32
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$26,601.14
|
| Rate for Payer: Elderplan Medicare Advantage |
$31,552.06
|
| Rate for Payer: EmblemHealth Commercial |
$16,006.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$33,212.70
|
| Rate for Payer: Group Health Inc Commercial |
$33,212.70
|
| Rate for Payer: Group Health Inc Medicare |
$33,212.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$33,212.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15,443.91
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$33,212.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$33,212.70
|
| Rate for Payer: Wellcare Medicare |
$31,552.06
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC
|
Facility
IP
|
$34,091.96
|
|
|
Service Code
|
MS-DRG 261
|
| Min. Negotiated Rate |
$15,541.92 |
| Max. Negotiated Rate |
$34,091.96 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$27,747.14
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$33,423.49
|
| Rate for Payer: Aetna Government |
$33,423.49
|
| Rate for Payer: Brighton Health Commercial |
$27,286.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$34,091.96
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$32,496.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$26,817.76
|
| Rate for Payer: Elderplan Medicare Advantage |
$31,752.32
|
| Rate for Payer: EmblemHealth Commercial |
$16,136.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$33,423.49
|
| Rate for Payer: Group Health Inc Commercial |
$33,423.49
|
| Rate for Payer: Group Health Inc Medicare |
$33,423.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$33,423.49
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15,541.92
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$33,423.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$33,423.49
|
| Rate for Payer: Wellcare Medicare |
$31,752.32
|
|
|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC
|
Facility
IP
|
$57,250.19
|
|
|
Service Code
|
MS-DRG 260
|
| Min. Negotiated Rate |
$24,784.96 |
| Max. Negotiated Rate |
$57,250.19 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$48,882.62
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$53,301.00
|
| Rate for Payer: Aetna Government |
$53,301.00
|
| Rate for Payer: Brighton Health Commercial |
$48,070.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$54,367.02
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$57,250.19
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$47,245.31
|
| Rate for Payer: Elderplan Medicare Advantage |
$50,635.95
|
| Rate for Payer: EmblemHealth Commercial |
$28,427.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$53,301.00
|
| Rate for Payer: Group Health Inc Commercial |
$53,301.00
|
| Rate for Payer: Group Health Inc Medicare |
$53,301.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$53,301.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$24,784.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$53,301.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$53,301.00
|
| Rate for Payer: Wellcare Medicare |
$50,635.95
|
|
