|
CATHETER, IV,AUTOG,INS,20GX1.16
|
Facility
|
OP
|
$3.96
|
|
| Hospital Charge Code |
64902490
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$3.17 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2.18
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.98
|
| Rate for Payer: Aetna Government |
$1.98
|
| Rate for Payer: Brighton Health Commercial |
$2.97
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.17
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2.69
|
| Rate for Payer: Group Health Inc Commercial |
$1.98
|
| Rate for Payer: Group Health Inc Medicare |
$1.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1.98
|
|
|
CATHETER, IV,AUTOG,INS,22GX1.00
|
Facility
|
OP
|
$3.96
|
|
| Hospital Charge Code |
64902494
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$3.17 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2.18
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.98
|
| Rate for Payer: Aetna Government |
$1.98
|
| Rate for Payer: Brighton Health Commercial |
$2.97
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.17
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2.69
|
| Rate for Payer: Group Health Inc Commercial |
$1.98
|
| Rate for Payer: Group Health Inc Medicare |
$1.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1.98
|
|
|
CATHETER, IV,AUTOG,INS,24GX0.56
|
Facility
|
OP
|
$5.80
|
|
| Hospital Charge Code |
64903353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.03 |
| Max. Negotiated Rate |
$4.64 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.19
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2.90
|
| Rate for Payer: Aetna Government |
$2.90
|
| Rate for Payer: Brighton Health Commercial |
$4.35
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4.64
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$3.94
|
| Rate for Payer: Group Health Inc Commercial |
$2.90
|
| Rate for Payer: Group Health Inc Medicare |
$2.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2.90
|
|
|
CATHETER, IV,AUTOG,INS,24GX0.75
|
Facility
|
OP
|
$3.96
|
|
| Hospital Charge Code |
64902497
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$3.17 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2.18
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.98
|
| Rate for Payer: Aetna Government |
$1.98
|
| Rate for Payer: Brighton Health Commercial |
$2.97
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.17
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2.69
|
| Rate for Payer: Group Health Inc Commercial |
$1.98
|
| Rate for Payer: Group Health Inc Medicare |
$1.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1.98
|
|
|
CATHETER, IV, AUTOGUARD 14GX1.75
|
Facility
|
OP
|
$15.85
|
|
| Hospital Charge Code |
64902529
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$5.55 |
| Max. Negotiated Rate |
$12.68 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8.72
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$7.92
|
| Rate for Payer: Aetna Government |
$7.92
|
| Rate for Payer: Brighton Health Commercial |
$11.89
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$12.68
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$10.78
|
| Rate for Payer: Group Health Inc Commercial |
$7.92
|
| Rate for Payer: Group Health Inc Medicare |
$5.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$7.92
|
|
|
CATHETERIZATION
|
Facility
|
IP
|
$16,685.43
|
|
|
Service Code
|
HCPCS 62350
|
| Hospital Charge Code |
40000070
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$7,703.44
|
|
|
CATHETERIZATION
|
Facility
|
OP
|
$16,685.43
|
|
|
Service Code
|
HCPCS 62350
|
| Hospital Charge Code |
40000070
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$12,514.07 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$7,703.44
|
| Rate for Payer: Aetna Government |
$7,703.44
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5,392.41
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5,392.41
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5,392.41
|
| Rate for Payer: Brighton Health Commercial |
$12,514.07
|
| Rate for Payer: Cash Price |
$7,703.44
|
| Rate for Payer: Cash Price |
$7,703.44
|
| Rate for Payer: Cash Price |
$7,703.44
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$7,703.44
|
| 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 |
$7,703.44
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$6,547.92
|
| Rate for Payer: Fidelis Essential Plan QHP |
$6,856.06
|
| Rate for Payer: Fidelis Medicare Advantage |
$7,703.44
|
| Rate for Payer: Fidelis Qualified Health Plan |
$6,856.06
|
| Rate for Payer: Group Health Inc Commercial |
$7,703.44
|
| Rate for Payer: Group Health Inc Medicare |
$7,703.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8,342.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$7,703.44
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6,547.92
|
| Rate for Payer: Healthfirst QHP |
$7,703.44
|
| Rate for Payer: Humana Medicare |
$7,857.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$7,703.44
|
| Rate for Payer: United Healthcare Commercial |
$2,683.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,703.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7,703.44
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6,162.75
|
| Rate for Payer: Wellcare Medicare |
$7,318.27
|
|
|
Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 58340
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$72.24 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$72.24
|
| Rate for Payer: Aetna Government |
$72.24
|
| 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: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: United Healthcare Commercial |
$1,113.00
|
|
|
Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 58340
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$72.24 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$72.24
|
| Rate for Payer: Aetna Government |
$72.24
|
| 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: United Healthcare Commercial |
$1,113.00
|
|
|
CATHETERIZATION CARE SET
|
Facility
|
OP
|
$6.73
|
|
| Hospital Charge Code |
40200912
|
|
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
|
|
|
CATHETERIZATION SET
|
Facility
|
OP
|
$14.53
|
|
| Hospital Charge Code |
40200910
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.09 |
| Max. Negotiated Rate |
$11.62 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.99
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$7.26
|
| Rate for Payer: Aetna Government |
$7.26
|
| Rate for Payer: Brighton Health Commercial |
$10.90
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$11.62
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9.88
|
| Rate for Payer: Group Health Inc Commercial |
$7.26
|
| Rate for Payer: Group Health Inc Medicare |
$5.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$7.26
|
|
|
CATHETERIZATION SET
|
Facility
|
OP
|
$7.09
|
|
| Hospital Charge Code |
40190940
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$5.67 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.90
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.54
|
| Rate for Payer: Aetna Government |
$3.54
|
| Rate for Payer: Brighton Health Commercial |
$5.32
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.67
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.82
|
| Rate for Payer: Group Health Inc Commercial |
$3.54
|
| Rate for Payer: Group Health Inc Medicare |
$2.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.54
|
|
|
CATHETER KIT & BIOPATCH (HEMO)
|
Facility
|
OP
|
$28.38
|
|
| Hospital Charge Code |
42905342
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$22.70 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15.61
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$14.19
|
| Rate for Payer: Aetna Government |
$14.19
|
| Rate for Payer: Brighton Health Commercial |
$21.28
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22.70
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$19.30
|
| Rate for Payer: Group Health Inc Commercial |
$14.19
|
| Rate for Payer: Group Health Inc Medicare |
$9.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.19
|
|
|
CATHETER KOALA INTRAUT W EXT
|
Facility
|
OP
|
$55.63
|
|
| Hospital Charge Code |
64903826
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$19.47 |
| Max. Negotiated Rate |
$44.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$30.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$27.82
|
| Rate for Payer: Aetna Government |
$27.82
|
| Rate for Payer: Brighton Health Commercial |
$41.72
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$44.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$37.83
|
| Rate for Payer: Group Health Inc Commercial |
$27.82
|
| Rate for Payer: Group Health Inc Medicare |
$19.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$27.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$27.82
|
|
|
CATHETER MAHURKR MAXI 14.5F 23CM
|
Facility
|
OP
|
$1,029.40
|
|
| Hospital Charge Code |
64904318
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$360.29 |
| Max. Negotiated Rate |
$823.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$566.17
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$514.70
|
| Rate for Payer: Aetna Government |
$514.70
|
| Rate for Payer: Brighton Health Commercial |
$772.05
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$823.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$699.99
|
| Rate for Payer: Group Health Inc Commercial |
$514.70
|
| Rate for Payer: Group Health Inc Medicare |
$360.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$514.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$514.70
|
|
|
CATHETER MALECOT 22FR
|
Facility
|
OP
|
$61.10
|
|
| Hospital Charge Code |
64904236
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$21.38 |
| Max. Negotiated Rate |
$48.88 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$33.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$30.55
|
| Rate for Payer: Aetna Government |
$30.55
|
| Rate for Payer: Brighton Health Commercial |
$45.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$48.88
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$41.55
|
| Rate for Payer: Group Health Inc Commercial |
$30.55
|
| Rate for Payer: Group Health Inc Medicare |
$21.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.55
|
|
|
CATHETER MALECOT 24FR
|
Facility
|
OP
|
$61.10
|
|
| Hospital Charge Code |
64904017
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$21.38 |
| Max. Negotiated Rate |
$48.88 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$33.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$30.55
|
| Rate for Payer: Aetna Government |
$30.55
|
| Rate for Payer: Brighton Health Commercial |
$45.82
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$48.88
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$41.55
|
| Rate for Payer: Group Health Inc Commercial |
$30.55
|
| Rate for Payer: Group Health Inc Medicare |
$21.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.55
|
|
|
CATHETER MALECOT 28FR
|
Facility
|
OP
|
$259.98
|
|
| Hospital Charge Code |
64903973
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$90.99 |
| Max. Negotiated Rate |
$207.98 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$142.99
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$129.99
|
| Rate for Payer: Aetna Government |
$129.99
|
| Rate for Payer: Brighton Health Commercial |
$194.98
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$207.98
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$176.79
|
| Rate for Payer: Group Health Inc Commercial |
$129.99
|
| Rate for Payer: Group Health Inc Medicare |
$90.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$129.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$129.99
|
|
|
CATHETER,PACING SVC INSERTION
|
Facility
|
OP
|
$174.80
|
|
| Hospital Charge Code |
64901500
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$61.18 |
| Max. Negotiated Rate |
$139.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$96.14
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$87.40
|
| Rate for Payer: Aetna Government |
$87.40
|
| Rate for Payer: Brighton Health Commercial |
$131.10
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$139.84
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$118.86
|
| Rate for Payer: Group Health Inc Commercial |
$87.40
|
| Rate for Payer: Group Health Inc Medicare |
$61.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$87.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$87.40
|
|
|
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;
|
Facility
|
OP
|
$6,937.00
|
|
|
Service Code
|
CPT 93454
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,637.79 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,768.27
|
| Rate for Payer: Aetna Government |
$3,768.27
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,637.79
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,637.79
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,637.79
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,768.27
|
| 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: Elderplan Medicare Advantage |
$3,768.27
|
| Rate for Payer: EmblemHealth Commercial |
$3,768.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,203.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,353.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,768.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,353.76
|
| Rate for Payer: Group Health Inc Commercial |
$3,768.27
|
| Rate for Payer: Group Health Inc Medicare |
$3,768.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,768.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,203.03
|
| Rate for Payer: Healthfirst QHP |
$3,768.27
|
| Rate for Payer: Humana Medicare |
$3,843.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,768.27
|
| Rate for Payer: United Healthcare Commercial |
$3,955.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,768.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,768.27
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,014.62
|
| Rate for Payer: Wellcare Medicare |
$3,579.86
|
|
|
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed
|
Facility
|
OP
|
$6,937.00
|
|
|
Service Code
|
CPT 93458
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,637.79 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,768.27
|
| Rate for Payer: Aetna Government |
$3,768.27
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,637.79
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,637.79
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,637.79
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,768.27
|
| 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: Elderplan Medicare Advantage |
$3,768.27
|
| Rate for Payer: EmblemHealth Commercial |
$3,768.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,203.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,353.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,768.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,353.76
|
| Rate for Payer: Group Health Inc Commercial |
$3,768.27
|
| Rate for Payer: Group Health Inc Medicare |
$3,768.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,768.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,203.03
|
| Rate for Payer: Healthfirst QHP |
$3,768.27
|
| Rate for Payer: Humana Medicare |
$3,843.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,768.27
|
| Rate for Payer: United Healthcare Commercial |
$3,955.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,768.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,768.27
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,014.62
|
| Rate for Payer: Wellcare Medicare |
$3,579.86
|
|
|
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed, catheter placement(s) in bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass graft angiography
|
Facility
|
OP
|
$6,937.00
|
|
|
Service Code
|
CPT 93459
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,637.79 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,768.27
|
| Rate for Payer: Aetna Government |
$3,768.27
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,637.79
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,637.79
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,637.79
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,768.27
|
| 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: Elderplan Medicare Advantage |
$3,768.27
|
| Rate for Payer: EmblemHealth Commercial |
$3,768.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,203.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,353.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,768.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,353.76
|
| Rate for Payer: Group Health Inc Commercial |
$3,768.27
|
| Rate for Payer: Group Health Inc Medicare |
$3,768.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,768.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,203.03
|
| Rate for Payer: Healthfirst QHP |
$3,768.27
|
| Rate for Payer: Humana Medicare |
$3,843.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,768.27
|
| Rate for Payer: United Healthcare Commercial |
$3,955.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,768.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,768.27
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,014.62
|
| Rate for Payer: Wellcare Medicare |
$3,579.86
|
|
|
Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation; with right and left heart catheterization including intraprocedural injection(s) for left ventriculography, when performed
|
Facility
|
OP
|
$6,937.00
|
|
|
Service Code
|
CPT 93460
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,637.79 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,768.27
|
| Rate for Payer: Aetna Government |
$3,768.27
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,637.79
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,637.79
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,637.79
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,768.27
|
| 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: Elderplan Medicare Advantage |
$3,768.27
|
| Rate for Payer: EmblemHealth Commercial |
$3,768.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,203.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,353.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,768.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,353.76
|
| Rate for Payer: Group Health Inc Commercial |
$3,768.27
|
| Rate for Payer: Group Health Inc Medicare |
$3,768.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,768.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,203.03
|
| Rate for Payer: Healthfirst QHP |
$3,768.27
|
| Rate for Payer: Humana Medicare |
$3,843.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,768.27
|
| Rate for Payer: United Healthcare Commercial |
$3,955.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,768.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,768.27
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,014.62
|
| Rate for Payer: Wellcare Medicare |
$3,579.86
|
|
|
CATHETER RECTAL 42CM
|
Facility
|
OP
|
$384.00
|
|
| Hospital Charge Code |
40201055
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$134.40 |
| Max. Negotiated Rate |
$307.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$211.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$192.00
|
| Rate for Payer: Aetna Government |
$192.00
|
| Rate for Payer: Brighton Health Commercial |
$288.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$307.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$261.12
|
| Rate for Payer: Group Health Inc Commercial |
$192.00
|
| Rate for Payer: Group Health Inc Medicare |
$134.40
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$192.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$192.00
|
|
|
CATHETER RED RUBBER 14FR
|
Facility
|
OP
|
$118.00
|
|
| Hospital Charge Code |
40201056
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$41.30 |
| Max. Negotiated Rate |
$94.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$64.90
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$59.00
|
| Rate for Payer: Aetna Government |
$59.00
|
| Rate for Payer: Brighton Health Commercial |
$88.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$94.40
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$80.24
|
| Rate for Payer: Group Health Inc Commercial |
$59.00
|
| Rate for Payer: Group Health Inc Medicare |
$41.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$59.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$59.00
|
|
