|
CC INJECT PULM ART HRT CATH
|
Facility
OP
|
$510.00
|
|
|
Service Code
|
HCPCS 93568
|
| Hospital Charge Code |
66528876
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$43.85 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$43.85
|
| Rate for Payer: Aetna Government |
$43.85
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4,959.74
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4,215.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$53.17
|
| Rate for Payer: Group Health Inc Commercial |
$255.00
|
| Rate for Payer: Group Health Inc Medicare |
$178.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$255.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$255.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$59.08
|
|
|
CC INJECT R VENTR/ATRIAL ANGIO
|
Facility
OP
|
$524.33
|
|
|
Service Code
|
HCPCS 93566
|
| Hospital Charge Code |
66528891
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$29.79 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$154.83
|
| Rate for Payer: Aetna Government |
$154.83
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4,959.74
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4,215.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$29.79
|
| Rate for Payer: Group Health Inc Commercial |
$262.16
|
| Rate for Payer: Group Health Inc Medicare |
$183.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$262.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$262.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$33.10
|
|
|
CC INJECT SUPRVLV AORTOGRAPHY
|
Facility
OP
|
$427.75
|
|
|
Service Code
|
HCPCS 93567
|
| Hospital Charge Code |
66528867
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$43.38 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$48.82
|
| Rate for Payer: Aetna Government |
$48.82
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4,959.74
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4,215.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$43.38
|
| Rate for Payer: Group Health Inc Commercial |
$213.88
|
| Rate for Payer: Group Health Inc Medicare |
$149.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$213.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$213.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$48.20
|
|
|
CC INS CATH REN ART 1ST BILAT
|
Facility
OP
|
$8,393.53
|
|
|
Service Code
|
HCPCS 36252
|
| Hospital Charge Code |
66528251
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$400.79 |
| Max. Negotiated Rate |
$4,196.76 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,686.08
|
| Rate for Payer: Aetna Government |
$3,686.08
|
| Rate for Payer: Cash Price |
$3,686.08
|
| Rate for Payer: Cash Price |
$3,686.08
|
| Rate for Payer: Cash Price |
$3,686.08
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,686.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$3,686.08
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$400.79
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,133.17
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,280.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,686.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,280.61
|
| Rate for Payer: Group Health Inc Commercial |
$3,686.08
|
| Rate for Payer: Group Health Inc Medicare |
$3,686.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,196.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,686.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$445.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,133.17
|
| Rate for Payer: Healthfirst QHP |
$3,686.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,686.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,686.08
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,948.86
|
| Rate for Payer: Wellcare Medicare |
$3,501.78
|
|
|
CC INSERTION KIT
|
Facility
OP
|
$250.00
|
|
| Hospital Charge Code |
66528272
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$87.50 |
| Max. Negotiated Rate |
$200.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$137.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$125.00
|
| Rate for Payer: Aetna Government |
$125.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$200.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$170.00
|
| Rate for Payer: Group Health Inc Commercial |
$125.00
|
| Rate for Payer: Group Health Inc Medicare |
$87.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$125.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$125.00
|
|
|
CC INSERT LEAD PACE-DEFIB, DUAL
|
Facility
OP
|
$23,145.25
|
|
|
Service Code
|
HCPCS 33217
|
| Hospital Charge Code |
66528636
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$418.46 |
| Max. Negotiated Rate |
$11,572.62 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5,593.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9,824.59
|
| Rate for Payer: Aetna Government |
$9,824.59
|
| Rate for Payer: Cash Price |
$9,824.59
|
| Rate for Payer: Cash Price |
$9,824.59
|
| Rate for Payer: Cash Price |
$9,824.59
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9,824.59
|
| 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 |
$9,824.59
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$418.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8,350.90
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8,743.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$9,824.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8,743.89
|
| Rate for Payer: Group Health Inc Commercial |
$9,824.59
|
| Rate for Payer: Group Health Inc Medicare |
$9,824.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11,572.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9,824.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$464.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8,350.90
|
| Rate for Payer: Healthfirst QHP |
$9,824.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9,824.59
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9,824.59
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$7,859.67
|
| Rate for Payer: Wellcare Medicare |
$9,333.36
|
|
|
CC INSERT PACING LEAD & CONNECT
|
Facility
OP
|
$31,050.58
|
|
|
Service Code
|
HCPCS 33224
|
| Hospital Charge Code |
66528651
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$582.64 |
| Max. Negotiated Rate |
$44,507.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$44,507.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12,348.58
|
| Rate for Payer: Aetna Government |
$12,348.58
|
| Rate for Payer: Cash Price |
$12,348.58
|
| Rate for Payer: Cash Price |
$12,348.58
|
| Rate for Payer: Cash Price |
$12,348.58
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12,348.58
|
| 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 |
$12,348.58
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$582.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10,496.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10,990.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$12,348.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10,990.24
|
| Rate for Payer: Group Health Inc Commercial |
$12,348.58
|
| Rate for Payer: Group Health Inc Medicare |
$12,348.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15,525.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12,348.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$647.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,496.29
|
| Rate for Payer: Healthfirst QHP |
$12,348.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12,348.58
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12,348.58
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9,878.86
|
| Rate for Payer: Wellcare Medicare |
$11,731.15
|
|
|
CC INS/REP ELECTRODE LEADS W INS
|
Facility
OP
|
$98,886.00
|
|
|
Service Code
|
HCPCS 33249
|
| Hospital Charge Code |
66528643
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,037.58 |
| Max. Negotiated Rate |
$49,443.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$44,507.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$38,045.24
|
| Rate for Payer: Aetna Government |
$38,045.24
|
| Rate for Payer: Cash Price |
$38,045.24
|
| Rate for Payer: Cash Price |
$38,045.24
|
| Rate for Payer: Cash Price |
$38,045.24
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$38,045.24
|
| 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 |
$38,045.24
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,037.58
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$32,338.45
|
| Rate for Payer: Fidelis Essential Plan QHP |
$33,860.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$38,045.24
|
| Rate for Payer: Fidelis Qualified Health Plan |
$33,860.26
|
| Rate for Payer: Group Health Inc Commercial |
$38,045.24
|
| Rate for Payer: Group Health Inc Medicare |
$38,045.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$49,443.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$38,045.24
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,152.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$32,338.45
|
| Rate for Payer: Healthfirst QHP |
$38,045.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$38,045.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$38,045.24
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$30,436.19
|
| Rate for Payer: Wellcare Medicare |
$36,142.98
|
|
|
CC INS/REPL PERM PACEMAKER, AV
|
Facility
OP
|
$30,076.00
|
|
|
Service Code
|
HCPCS 33208
|
| Hospital Charge Code |
66528625
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$589.20 |
| Max. Negotiated Rate |
$22,108.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$22,108.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12,348.58
|
| Rate for Payer: Aetna Government |
$12,348.58
|
| Rate for Payer: Cash Price |
$12,348.58
|
| Rate for Payer: Cash Price |
$12,348.58
|
| Rate for Payer: Cash Price |
$12,348.58
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12,348.58
|
| 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 |
$12,348.58
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$589.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10,496.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10,990.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$12,348.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10,990.24
|
| Rate for Payer: Group Health Inc Commercial |
$12,348.58
|
| Rate for Payer: Group Health Inc Medicare |
$12,348.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15,038.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12,348.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$654.67
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,496.29
|
| Rate for Payer: Healthfirst QHP |
$12,348.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12,348.58
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12,348.58
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9,878.86
|
| Rate for Payer: Wellcare Medicare |
$11,731.15
|
|
|
CC INS/REPL PG ONLY, DUAL CHAMBER
|
Facility
OP
|
$31,050.58
|
|
|
Service Code
|
HCPCS 33213
|
| Hospital Charge Code |
66528628
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$382.08 |
| Max. Negotiated Rate |
$15,525.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12,348.58
|
| Rate for Payer: Aetna Government |
$12,348.58
|
| Rate for Payer: Cash Price |
$12,348.58
|
| Rate for Payer: Cash Price |
$12,348.58
|
| Rate for Payer: Cash Price |
$12,348.58
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12,348.58
|
| 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 |
$12,348.58
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$382.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10,496.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10,990.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$12,348.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10,990.24
|
| Rate for Payer: Group Health Inc Commercial |
$12,348.58
|
| Rate for Payer: Group Health Inc Medicare |
$12,348.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15,525.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12,348.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$424.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,496.29
|
| Rate for Payer: Healthfirst QHP |
$12,348.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12,348.58
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12,348.58
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$9,878.86
|
| Rate for Payer: Wellcare Medicare |
$11,731.15
|
|
|
CC INS/REPL PG ONLY, SGL CHAMBER
|
Facility
OP
|
$23,145.25
|
|
|
Service Code
|
HCPCS 33212
|
| Hospital Charge Code |
66528629
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$365.43 |
| Max. Negotiated Rate |
$11,572.62 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9,824.59
|
| Rate for Payer: Aetna Government |
$9,824.59
|
| Rate for Payer: Cash Price |
$9,824.59
|
| Rate for Payer: Cash Price |
$9,824.59
|
| Rate for Payer: Cash Price |
$9,824.59
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9,824.59
|
| 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 |
$9,824.59
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$365.43
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8,350.90
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8,743.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$9,824.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8,743.89
|
| Rate for Payer: Group Health Inc Commercial |
$9,824.59
|
| Rate for Payer: Group Health Inc Medicare |
$9,824.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11,572.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9,824.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$406.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8,350.90
|
| Rate for Payer: Healthfirst QHP |
$9,824.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9,824.59
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9,824.59
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$7,859.67
|
| Rate for Payer: Wellcare Medicare |
$9,333.36
|
|
|
CC INS TEMP BLADDER CATH
|
Facility
OP
|
$330.23
|
|
|
Service Code
|
HCPCS 51702
|
| Hospital Charge Code |
66528669
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$26.98 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$147.72
|
| Rate for Payer: Aetna Government |
$147.72
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$147.72
|
| 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 |
$147.72
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$26.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$125.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$131.47
|
| Rate for Payer: Fidelis Medicare Advantage |
$147.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$131.47
|
| Rate for Payer: Group Health Inc Commercial |
$147.72
|
| Rate for Payer: Group Health Inc Medicare |
$147.72
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$165.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$147.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$125.56
|
| Rate for Payer: Healthfirst QHP |
$147.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$147.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$147.72
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$118.18
|
| Rate for Payer: Wellcare Medicare |
$140.33
|
|
|
CC INS TV SCP ELECTRODE
|
Facility
OP
|
$23,145.25
|
|
|
Service Code
|
HCPCS 33216
|
| Hospital Charge Code |
66528635
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$422.72 |
| Max. Negotiated Rate |
$11,572.62 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5,593.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9,824.59
|
| Rate for Payer: Aetna Government |
$9,824.59
|
| Rate for Payer: Cash Price |
$9,824.59
|
| Rate for Payer: Cash Price |
$9,824.59
|
| Rate for Payer: Cash Price |
$9,824.59
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9,824.59
|
| 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 |
$9,824.59
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$422.72
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8,350.90
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8,743.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$9,824.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8,743.89
|
| Rate for Payer: Group Health Inc Commercial |
$9,824.59
|
| Rate for Payer: Group Health Inc Medicare |
$9,824.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11,572.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9,824.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$469.69
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8,350.90
|
| Rate for Payer: Healthfirst QHP |
$9,824.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9,824.59
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9,824.59
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$7,859.67
|
| Rate for Payer: Wellcare Medicare |
$9,333.36
|
|
|
CC INTRACARDIAC ECHOCARDIOGRAPHY
|
Facility
OP
|
$435.75
|
|
|
Service Code
|
HCPCS 93662 TC
|
| Hospital Charge Code |
66528378
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$152.51 |
| Max. Negotiated Rate |
$348.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$239.66
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$217.88
|
| Rate for Payer: Aetna Government |
$217.88
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$348.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$296.31
|
| Rate for Payer: Group Health Inc Commercial |
$217.88
|
| Rate for Payer: Group Health Inc Medicare |
$152.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$217.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$217.88
|
|
|
CC INTRAVASCULAR US 1ST VESSEL
|
Facility
OP
|
$874.88
|
|
|
Service Code
|
HCPCS 92978 TC
|
| Hospital Charge Code |
66528393
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$306.21 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$481.18
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$437.44
|
| Rate for Payer: Aetna Government |
$437.44
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4,959.74
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4,215.78
|
| Rate for Payer: Group Health Inc Commercial |
$437.44
|
| Rate for Payer: Group Health Inc Medicare |
$306.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$437.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$437.44
|
|
|
CC INTRAVASCULAR US 2ND VESSEL
|
Facility
OP
|
$518.60
|
|
|
Service Code
|
HCPCS 92998
|
| Hospital Charge Code |
66528392
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$181.51 |
| Max. Negotiated Rate |
$414.88 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$285.23
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$301.43
|
| Rate for Payer: Aetna Government |
$301.43
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$414.88
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$352.65
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$356.24
|
| Rate for Payer: Group Health Inc Commercial |
$259.30
|
| Rate for Payer: Group Health Inc Medicare |
$181.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$259.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$259.30
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$395.82
|
|
|
CC INTRO HLS1007M 5PK
|
Facility
OP
|
$117.00
|
|
| Hospital Charge Code |
66526889
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.95 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$64.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$58.50
|
| Rate for Payer: Aetna Government |
$58.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$93.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$79.56
|
| Rate for Payer: Group Health Inc Commercial |
$58.50
|
| Rate for Payer: Group Health Inc Medicare |
$40.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$58.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$58.50
|
|
|
CC INTRO SHEATH PRELUDE MIN
|
Facility
IP
|
$450.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
66528884
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$225.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$225.00
|
|
|
CC INTRO SHEATH PRELUDE MIN
|
Facility
OP
|
$450.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
66528884
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$472.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$247.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.82
|
| Rate for Payer: Aetna Government |
$0.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$225.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$258.75
|
| Rate for Payer: Fidelis Medicare Advantage |
$472.50
|
| Rate for Payer: Group Health Inc Commercial |
$225.00
|
| Rate for Payer: Group Health Inc Medicare |
$157.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$225.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$225.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$292.50
|
|
|
CCIPG ADAPTA DR, IS-1 US
|
Facility
OP
|
$10,512.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
66526897
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$275.42 |
| Max. Negotiated Rate |
$11,037.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5,781.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$275.42
|
| Rate for Payer: Aetna Government |
$275.42
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5,256.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6,044.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$11,037.60
|
| Rate for Payer: Group Health Inc Commercial |
$5,256.00
|
| Rate for Payer: Group Health Inc Medicare |
$3,679.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5,256.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5,256.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,832.80
|
|
|
CC IPG VEDR01 VERSA IS-1 DR USA
|
Facility
OP
|
$11,236.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
66526885
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$275.42 |
| Max. Negotiated Rate |
$11,797.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$6,179.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$275.42
|
| Rate for Payer: Aetna Government |
$275.42
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5,618.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6,460.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$11,797.80
|
| Rate for Payer: Group Health Inc Commercial |
$5,618.00
|
| Rate for Payer: Group Health Inc Medicare |
$3,932.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5,618.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5,618.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7,303.40
|
|
|
CC IV DOPPLER, EA ADDTL VESSEL
|
Facility
OP
|
$477.63
|
|
|
Service Code
|
HCPCS 93572 TC
|
| Hospital Charge Code |
66520306
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$167.17 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$262.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$238.82
|
| Rate for Payer: Aetna Government |
$238.82
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4,959.74
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4,215.78
|
| Rate for Payer: Group Health Inc Commercial |
$238.82
|
| Rate for Payer: Group Health Inc Medicare |
$167.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$238.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$238.82
|
|
|
CC IV DOPPLER, INITIAL VESSEL
|
Facility
OP
|
$891.63
|
|
|
Service Code
|
HCPCS 93571 TC
|
| Hospital Charge Code |
66520305
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$312.07 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$490.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$445.82
|
| Rate for Payer: Aetna Government |
$445.82
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4,959.74
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4,215.78
|
| Rate for Payer: Group Health Inc Commercial |
$445.82
|
| Rate for Payer: Group Health Inc Medicare |
$312.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$445.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$445.82
|
|
|
CC IV DRUG INFUSION
|
Facility
OP
|
$556.50
|
|
|
Service Code
|
HCPCS 96360
|
| Hospital Charge Code |
66528391
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$35.38 |
| Max. Negotiated Rate |
$445.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$306.08
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$247.87
|
| Rate for Payer: Aetna Government |
$247.87
|
| Rate for Payer: Cash Price |
$247.87
|
| Rate for Payer: Cash Price |
$247.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$247.87
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$445.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$378.42
|
| Rate for Payer: Elderplan Medicare Advantage |
$247.87
|
| Rate for Payer: EmblemHealth Commercial |
$247.87
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$35.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$210.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$220.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$247.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$220.60
|
| Rate for Payer: Group Health Inc Commercial |
$247.87
|
| Rate for Payer: Group Health Inc Medicare |
$247.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$278.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$247.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$39.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$210.69
|
| Rate for Payer: Healthfirst QHP |
$247.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$247.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$247.87
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$198.30
|
| Rate for Payer: Wellcare Medicare |
$235.48
|
|
|
CC IVUS/FFR VOLCANO REV CATH
|
Facility
OP
|
$1,300.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
66521093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$44.85 |
| Max. Negotiated Rate |
$1,365.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$715.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$44.85
|
| Rate for Payer: Aetna Government |
$44.85
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$650.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$747.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,365.00
|
| Rate for Payer: Group Health Inc Commercial |
$650.00
|
| Rate for Payer: Group Health Inc Medicare |
$455.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$650.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$650.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$845.00
|
|
