|
CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$41,447.79
|
|
|
Service Code
|
MSDRG 262
|
| Min. Negotiated Rate |
$14,016.89 |
| Max. Negotiated Rate |
$41,447.79 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$24,259.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$30,143.85
|
| Rate for Payer: Aetna Government |
$30,143.85
|
| Rate for Payer: Brighton Health Commercial |
$23,856.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$30,746.73
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$28,412.69
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$23,447.37
|
| Rate for Payer: Elderplan Medicare Advantage |
$28,636.66
|
| Rate for Payer: EmblemHealth Commercial |
$14,108.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$30,143.85
|
| Rate for Payer: Group Health Inc Commercial |
$30,143.85
|
| Rate for Payer: Group Health Inc Medicare |
$30,143.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30,143.85
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14,016.89
|
| Rate for Payer: Humana Medicare |
$41,447.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$30,143.85
|
| Rate for Payer: United Healthcare Commercial |
$32,720.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$30,143.85
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$30,143.85
|
| Rate for Payer: Wellcare Medicare |
$28,636.66
|
|
|
CARDIAC TRAY (RU)
|
Facility
|
OP
|
$57.76
|
|
| Hospital Charge Code |
40207809
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.22 |
| Max. Negotiated Rate |
$46.21 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$31.77
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$28.88
|
| Rate for Payer: Aetna Government |
$28.88
|
| Rate for Payer: Brighton Health Commercial |
$43.32
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$46.21
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$39.28
|
| Rate for Payer: Group Health Inc Commercial |
$28.88
|
| Rate for Payer: Group Health Inc Medicare |
$20.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$28.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$28.88
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC
|
Facility
|
IP
|
$131,447.14
|
|
|
Service Code
|
MSDRG 217
|
| Min. Negotiated Rate |
$44,453.03 |
| Max. Negotiated Rate |
$131,447.14 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$93,856.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$95,597.92
|
| Rate for Payer: Aetna Government |
$95,597.92
|
| Rate for Payer: Brighton Health Commercial |
$92,296.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$97,509.88
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$109,922.37
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$90,712.65
|
| Rate for Payer: Elderplan Medicare Advantage |
$90,818.02
|
| Rate for Payer: EmblemHealth Commercial |
$54,582.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$95,597.92
|
| Rate for Payer: Group Health Inc Commercial |
$95,597.92
|
| Rate for Payer: Group Health Inc Medicare |
$95,597.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$95,597.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$44,453.03
|
| Rate for Payer: Humana Medicare |
$131,447.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$95,597.92
|
| Rate for Payer: United Healthcare Commercial |
$126,586.72
|
| Rate for Payer: United Healthcare Medicare Advantage |
$95,597.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$95,597.92
|
| Rate for Payer: Wellcare Medicare |
$90,818.02
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$195,133.07
|
|
|
Service Code
|
MSDRG 216
|
| Min. Negotiated Rate |
$65,990.46 |
| Max. Negotiated Rate |
$195,133.07 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$143,104.65
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$141,914.96
|
| Rate for Payer: Aetna Government |
$141,914.96
|
| Rate for Payer: Brighton Health Commercial |
$140,726.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$144,753.26
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$167,600.83
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$138,311.39
|
| Rate for Payer: Elderplan Medicare Advantage |
$134,819.21
|
| Rate for Payer: EmblemHealth Commercial |
$83,222.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$141,914.96
|
| Rate for Payer: Group Health Inc Commercial |
$141,914.96
|
| Rate for Payer: Group Health Inc Medicare |
$141,914.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$141,914.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$65,990.46
|
| Rate for Payer: Humana Medicare |
$195,133.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$141,914.96
|
| Rate for Payer: United Healthcare Commercial |
$193,009.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$141,914.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$141,914.96
|
| Rate for Payer: Wellcare Medicare |
$134,819.21
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$118,698.48
|
|
|
Service Code
|
MSDRG 218
|
| Min. Negotiated Rate |
$40,141.67 |
| Max. Negotiated Rate |
$118,698.48 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$83,997.84
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$86,326.17
|
| Rate for Payer: Aetna Government |
$86,326.17
|
| Rate for Payer: Brighton Health Commercial |
$82,602.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$88,052.69
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$98,376.31
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$81,184.36
|
| Rate for Payer: Elderplan Medicare Advantage |
$82,009.86
|
| Rate for Payer: EmblemHealth Commercial |
$48,849.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$86,326.17
|
| Rate for Payer: Group Health Inc Commercial |
$86,326.17
|
| Rate for Payer: Group Health Inc Medicare |
$86,326.17
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$86,326.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$40,141.67
|
| Rate for Payer: Humana Medicare |
$118,698.48
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$86,326.17
|
| Rate for Payer: United Healthcare Commercial |
$113,290.27
|
| Rate for Payer: United Healthcare Medicare Advantage |
$86,326.17
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$86,326.17
|
| Rate for Payer: Wellcare Medicare |
$82,009.86
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC
|
Facility
|
IP
|
$110,077.99
|
|
|
Service Code
|
MSDRG 220
|
| Min. Negotiated Rate |
$37,226.37 |
| Max. Negotiated Rate |
$110,077.99 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$77,331.63
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$80,056.72
|
| Rate for Payer: Aetna Government |
$80,056.72
|
| Rate for Payer: Brighton Health Commercial |
$76,046.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$81,657.85
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$90,569.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$74,741.42
|
| Rate for Payer: Elderplan Medicare Advantage |
$76,053.88
|
| Rate for Payer: EmblemHealth Commercial |
$44,972.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$80,056.72
|
| Rate for Payer: Group Health Inc Commercial |
$80,056.72
|
| Rate for Payer: Group Health Inc Medicare |
$80,056.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$80,056.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$37,226.37
|
| Rate for Payer: Humana Medicare |
$110,077.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$80,056.72
|
| Rate for Payer: United Healthcare Commercial |
$104,299.36
|
| Rate for Payer: United Healthcare Medicare Advantage |
$80,056.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$80,056.72
|
| Rate for Payer: Wellcare Medicare |
$76,053.88
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$157,110.28
|
|
|
Service Code
|
MSDRG 219
|
| Min. Negotiated Rate |
$53,131.84 |
| Max. Negotiated Rate |
$157,110.28 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$113,701.64
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$114,262.02
|
| Rate for Payer: Aetna Government |
$114,262.02
|
| Rate for Payer: Brighton Health Commercial |
$111,812.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$116,547.26
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$133,164.71
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$109,893.24
|
| Rate for Payer: Elderplan Medicare Advantage |
$108,548.92
|
| Rate for Payer: EmblemHealth Commercial |
$66,123.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$114,262.02
|
| Rate for Payer: Group Health Inc Commercial |
$114,262.02
|
| Rate for Payer: Group Health Inc Medicare |
$114,262.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$114,262.02
|
| Rate for Payer: Healthfirst Medicare Advantage |
$53,131.84
|
| Rate for Payer: Humana Medicare |
$157,110.28
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$114,262.02
|
| Rate for Payer: United Healthcare Commercial |
$153,352.63
|
| Rate for Payer: United Healthcare Medicare Advantage |
$114,262.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$114,262.02
|
| Rate for Payer: Wellcare Medicare |
$108,548.92
|
|
|
CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$98,713.68
|
|
|
Service Code
|
MSDRG 221
|
| Min. Negotiated Rate |
$33,383.17 |
| Max. Negotiated Rate |
$98,713.68 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$68,543.61
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$71,791.77
|
| Rate for Payer: Aetna Government |
$71,791.77
|
| Rate for Payer: Brighton Health Commercial |
$67,404.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$73,227.61
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$80,276.67
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$66,247.76
|
| Rate for Payer: Elderplan Medicare Advantage |
$68,202.18
|
| Rate for Payer: EmblemHealth Commercial |
$39,861.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$71,791.77
|
| Rate for Payer: Group Health Inc Commercial |
$71,791.77
|
| Rate for Payer: Group Health Inc Medicare |
$71,791.77
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$71,791.77
|
| Rate for Payer: Healthfirst Medicare Advantage |
$33,383.17
|
| Rate for Payer: Humana Medicare |
$98,713.68
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$71,791.77
|
| Rate for Payer: United Healthcare Commercial |
$92,446.71
|
| Rate for Payer: United Healthcare Medicare Advantage |
$71,791.77
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$71,791.77
|
| Rate for Payer: Wellcare Medicare |
$68,202.18
|
|
|
CARDINAL FRCPS IRIS BISHOP HARMAN
|
Facility
|
OP
|
$122.00
|
|
| Hospital Charge Code |
40200219
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$42.70 |
| Max. Negotiated Rate |
$97.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$67.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$61.00
|
| Rate for Payer: Aetna Government |
$61.00
|
| Rate for Payer: Brighton Health Commercial |
$91.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$97.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$82.96
|
| Rate for Payer: Group Health Inc Commercial |
$61.00
|
| Rate for Payer: Group Health Inc Medicare |
$42.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$61.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$61.00
|
|
|
CARDINAL STERILE PK SAN11PCMOG
|
Facility
|
OP
|
$440.80
|
|
| Hospital Charge Code |
66526610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$154.28 |
| Max. Negotiated Rate |
$352.64 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$242.44
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$220.40
|
| Rate for Payer: Aetna Government |
$220.40
|
| Rate for Payer: Brighton Health Commercial |
$330.60
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$352.64
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$299.74
|
| Rate for Payer: Group Health Inc Commercial |
$220.40
|
| Rate for Payer: Group Health Inc Medicare |
$154.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$220.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$220.40
|
|
|
CARDINAL TUBING INSUFFLATION SET
|
Facility
|
OP
|
$241.50
|
|
| Hospital Charge Code |
40009336
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.52 |
| Max. Negotiated Rate |
$193.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$132.82
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$120.75
|
| Rate for Payer: Aetna Government |
$120.75
|
| Rate for Payer: Brighton Health Commercial |
$181.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$193.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$164.22
|
| Rate for Payer: Group Health Inc Commercial |
$120.75
|
| Rate for Payer: Group Health Inc Medicare |
$84.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$120.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$120.75
|
|
|
CARDINAL TUBING INSUFFLATION SET
|
Facility
|
OP
|
$241.50
|
|
| Hospital Charge Code |
40203353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.52 |
| Max. Negotiated Rate |
$193.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$132.82
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$120.75
|
| Rate for Payer: Aetna Government |
$120.75
|
| Rate for Payer: Brighton Health Commercial |
$181.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$193.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$164.22
|
| Rate for Payer: Group Health Inc Commercial |
$120.75
|
| Rate for Payer: Group Health Inc Medicare |
$84.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$120.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$120.75
|
|
|
CARDIOPULMONARY RESUSCITATION
|
Facility
|
OP
|
$766.58
|
|
|
Service Code
|
HCPCS 92950
|
| Hospital Charge Code |
30103285
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$874.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$694.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$362.98
|
| Rate for Payer: Aetna Government |
$362.98
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$254.09
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$254.09
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$254.09
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$362.98
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$362.98
|
| Rate for Payer: Cash Price |
$362.98
|
| Rate for Payer: Cash Price |
$362.98
|
| Rate for Payer: Cash Price |
$362.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$362.98
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$747.30
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$635.21
|
| Rate for Payer: Elderplan Medicare Advantage |
$362.98
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$308.53
|
| Rate for Payer: Fidelis Essential Plan QHP |
$323.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$362.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$323.05
|
| Rate for Payer: Group Health Inc Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Medicare |
$525.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$383.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$362.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$362.98
|
| Rate for Payer: Humana Medicare |
$370.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$362.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$362.98
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$362.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$362.98
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$290.38
|
| Rate for Payer: Wellcare Medicare |
$344.83
|
|
|
CARDIOPULMONARY RESUSCITATION
|
Facility
|
IP
|
$766.58
|
|
|
Service Code
|
HCPCS 92950
|
| Hospital Charge Code |
30103285
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$362.98
|
|
|
CARDIOTOMY REMOVAL FOREIGN BODY
|
Facility
|
OP
|
$3,287.33
|
|
|
Service Code
|
HCPCS 33310
|
| Hospital Charge Code |
40034327
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,150.57 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,808.03
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,317.65
|
| Rate for Payer: Aetna Government |
$1,317.65
|
| Rate for Payer: Brighton Health Commercial |
$2,465.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Group Health Inc Commercial |
$1,643.66
|
| Rate for Payer: Group Health Inc Medicare |
$1,150.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,643.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,643.66
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
CARDIOTOMY WITH BYPASS
|
Facility
|
OP
|
$3,916.48
|
|
|
Service Code
|
HCPCS 33315
|
| Hospital Charge Code |
40034328
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,370.77 |
| Max. Negotiated Rate |
$2,937.36 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,154.06
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,137.98
|
| Rate for Payer: Aetna Government |
$2,137.98
|
| Rate for Payer: Brighton Health Commercial |
$2,937.36
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Group Health Inc Commercial |
$1,958.24
|
| Rate for Payer: Group Health Inc Medicare |
$1,370.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,958.24
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,958.24
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
CARDIOVAS 360 1.50 CRWNX145CM OAS
|
Facility
|
OP
|
$6,790.00
|
|
| Hospital Charge Code |
40008311
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,376.50 |
| Max. Negotiated Rate |
$5,432.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,734.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,395.00
|
| Rate for Payer: Aetna Government |
$3,395.00
|
| Rate for Payer: Brighton Health Commercial |
$5,092.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5,432.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4,617.20
|
| Rate for Payer: Group Health Inc Commercial |
$3,395.00
|
| Rate for Payer: Group Health Inc Medicare |
$2,376.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,395.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,395.00
|
|
|
CARDIOVERSION
|
Facility
|
IP
|
$1,624.80
|
|
|
Service Code
|
HCPCS 92960
|
| Hospital Charge Code |
30103284
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$752.63
|
|
|
CARDIOVERSION
|
Facility
|
OP
|
$1,624.80
|
|
|
Service Code
|
HCPCS 92960
|
| Hospital Charge Code |
30103284
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$874.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$694.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$752.63
|
| Rate for Payer: Aetna Government |
$752.63
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$526.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$526.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$526.84
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$752.63
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$752.63
|
| Rate for Payer: Cash Price |
$752.63
|
| Rate for Payer: Cash Price |
$752.63
|
| Rate for Payer: Cash Price |
$752.63
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$752.63
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$747.30
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$635.21
|
| Rate for Payer: Elderplan Medicare Advantage |
$752.63
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$639.74
|
| Rate for Payer: Fidelis Essential Plan QHP |
$669.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$752.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$669.84
|
| Rate for Payer: Group Health Inc Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Medicare |
$525.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$812.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$752.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$752.63
|
| Rate for Payer: Humana Medicare |
$767.68
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$752.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$752.63
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$752.63
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$752.63
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$602.10
|
| Rate for Payer: Wellcare Medicare |
$715.00
|
|
|
CARDIOVERSION ELECTRIC EXT
|
Facility
|
OP
|
$1,624.80
|
|
|
Service Code
|
HCPCS 92960
|
| Hospital Charge Code |
30103245
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$874.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$694.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$752.63
|
| Rate for Payer: Aetna Government |
$752.63
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$526.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$526.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$526.84
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$752.63
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$752.63
|
| Rate for Payer: Cash Price |
$752.63
|
| Rate for Payer: Cash Price |
$752.63
|
| Rate for Payer: Cash Price |
$752.63
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$752.63
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$747.30
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$635.21
|
| Rate for Payer: Elderplan Medicare Advantage |
$752.63
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$639.74
|
| Rate for Payer: Fidelis Essential Plan QHP |
$669.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$752.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$669.84
|
| Rate for Payer: Group Health Inc Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Medicare |
$525.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$812.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$752.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$752.63
|
| Rate for Payer: Humana Medicare |
$767.68
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$752.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$752.63
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$752.63
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$752.63
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$602.10
|
| Rate for Payer: Wellcare Medicare |
$715.00
|
|
|
CARDIOVERSION ELECTRIC EXT
|
Facility
|
IP
|
$1,624.80
|
|
|
Service Code
|
HCPCS 92960
|
| Hospital Charge Code |
30305085
|
|
Hospital Revenue Code
|
510
|
| Rate for Payer: Cash Price |
$752.63
|
|
|
CARDIOVERSION ELECTRIC EXT
|
Facility
|
OP
|
$1,624.80
|
|
|
Service Code
|
HCPCS 92960
|
| Hospital Charge Code |
30101134
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$874.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$694.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$752.63
|
| Rate for Payer: Aetna Government |
$752.63
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$526.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$526.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$526.84
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$752.63
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$752.63
|
| Rate for Payer: Cash Price |
$752.63
|
| Rate for Payer: Cash Price |
$752.63
|
| Rate for Payer: Cash Price |
$752.63
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$752.63
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$747.30
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$635.21
|
| Rate for Payer: Elderplan Medicare Advantage |
$752.63
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$639.74
|
| Rate for Payer: Fidelis Essential Plan QHP |
$669.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$752.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$669.84
|
| Rate for Payer: Group Health Inc Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Medicare |
$525.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$812.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$752.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$752.63
|
| Rate for Payer: Humana Medicare |
$767.68
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$752.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$752.63
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$752.63
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$752.63
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$602.10
|
| Rate for Payer: Wellcare Medicare |
$715.00
|
|
|
CARDIOVERSION ELECTRIC EXT
|
Facility
|
OP
|
$1,624.80
|
|
|
Service Code
|
HCPCS 92960
|
| Hospital Charge Code |
30305085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$173.89 |
| Max. Negotiated Rate |
$893.64 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$893.64
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$752.63
|
| Rate for Payer: Aetna Government |
$752.63
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$526.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$526.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$526.84
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$752.63
|
| Rate for Payer: Cash Price |
$752.63
|
| Rate for Payer: Cash Price |
$752.63
|
| Rate for Payer: Cash Price |
$752.63
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$752.63
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$204.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$173.89
|
| Rate for Payer: Elderplan Medicare Advantage |
$752.63
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$639.74
|
| Rate for Payer: Fidelis Essential Plan QHP |
$669.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$752.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$669.84
|
| 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 |
$812.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$752.63
|
| Rate for Payer: Healthfirst Medicare Advantage |
$639.74
|
| Rate for Payer: Healthfirst QHP |
$752.63
|
| Rate for Payer: Humana Medicare |
$767.68
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$752.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$752.63
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$752.63
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$752.63
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$602.10
|
| Rate for Payer: Wellcare Medicare |
$715.00
|
|
|
CARDIOVERSION ELECTRIC EXT
|
Facility
|
IP
|
$1,624.80
|
|
|
Service Code
|
HCPCS 92960
|
| Hospital Charge Code |
30103245
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$752.63
|
|
|
CARDIOVERSION ELECTRIC EXT
|
Facility
|
IP
|
$1,624.80
|
|
|
Service Code
|
HCPCS 92960
|
| Hospital Charge Code |
30101134
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$752.63
|
|
