|
CC REMOVE PPM OR PG
|
Facility
OP
|
$23,145.25
|
|
|
Service Code
|
HCPCS 33233
|
| Hospital Charge Code |
66528640
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$265.30 |
| Max. Negotiated Rate |
$11,572.62 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| 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 |
$265.30
|
| 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 |
$294.78
|
| 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 REM SC/DC ICD LEAD, TV EXTRACT
|
Facility
OP
|
$9,037.83
|
|
|
Service Code
|
HCPCS 33244
|
| Hospital Charge Code |
66528647
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$984.07 |
| Max. Negotiated Rate |
$4,541.28 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,541.28
|
| Rate for Payer: Aetna Government |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,541.28
|
| 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 |
$4,541.28
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$984.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,860.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4,041.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,541.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4,041.74
|
| Rate for Payer: Group Health Inc Commercial |
$4,541.28
|
| Rate for Payer: Group Health Inc Medicare |
$4,541.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,518.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,541.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,093.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,860.09
|
| Rate for Payer: Healthfirst QHP |
$4,541.28
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,541.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,541.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,633.02
|
| Rate for Payer: Wellcare Medicare |
$4,314.22
|
|
|
CC RENAL, BILATERAL & SELECT. INJ
|
Facility
OP
|
$3,839.45
|
|
|
Service Code
|
HCPCS 36245
|
| Hospital Charge Code |
66528385
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$258.53 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$278.84
|
| Rate for Payer: Aetna Government |
$278.84
|
| 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: Fidelis CHP/HARP/Medicaid |
$258.53
|
| Rate for Payer: Group Health Inc Commercial |
$1,919.72
|
| Rate for Payer: Group Health Inc Medicare |
$1,343.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,919.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,919.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$287.26
|
|
|
CC RENAL, BILATERAL & SELECTIVE
|
Facility
OP
|
$8,393.53
|
|
|
Service Code
|
HCPCS 36252
|
| Hospital Charge Code |
66528384
|
|
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 REP 2 TB ELECTRODES, DC PMKR/C
|
Facility
OP
|
$9,037.83
|
|
|
Service Code
|
HCPCS 33220
|
| Hospital Charge Code |
66528638
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$427.79 |
| Max. Negotiated Rate |
$4,541.28 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,541.28
|
| Rate for Payer: Aetna Government |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,541.28
|
| 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 |
$4,541.28
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$427.79
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,860.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4,041.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,541.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4,041.74
|
| Rate for Payer: Group Health Inc Commercial |
$4,541.28
|
| Rate for Payer: Group Health Inc Medicare |
$4,541.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,518.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,541.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$475.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,860.09
|
| Rate for Payer: Healthfirst QHP |
$4,541.28
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,541.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,541.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,633.02
|
| Rate for Payer: Wellcare Medicare |
$4,314.22
|
|
|
CC REPOSITION L VENTRIC LEAD
|
Facility
OP
|
$8,393.53
|
|
|
Service Code
|
HCPCS 33226
|
| Hospital Charge Code |
66528653
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$554.36 |
| Max. Negotiated Rate |
$4,196.76 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| 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 |
$554.36
|
| 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 |
$615.96
|
| 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 REPOSITION PACING-DEFIB LEAD
|
Facility
OP
|
$8,393.53
|
|
|
Service Code
|
HCPCS 33215
|
| Hospital Charge Code |
66528633
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$352.99 |
| Max. Negotiated Rate |
$4,196.76 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| 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 |
$352.99
|
| 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 |
$392.21
|
| 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 REP SGLE TV ELECTRODE,SCPMKR/C
|
Facility
OP
|
$9,037.83
|
|
|
Service Code
|
HCPCS 33218
|
| Hospital Charge Code |
66528637
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$442.73 |
| Max. Negotiated Rate |
$4,541.28 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,541.28
|
| Rate for Payer: Aetna Government |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,541.28
|
| 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 |
$4,541.28
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$442.73
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,860.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4,041.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,541.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4,041.74
|
| Rate for Payer: Group Health Inc Commercial |
$4,541.28
|
| Rate for Payer: Group Health Inc Medicare |
$4,541.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,518.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,541.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$491.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,860.09
|
| Rate for Payer: Healthfirst QHP |
$4,541.28
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,541.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,541.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,633.02
|
| Rate for Payer: Wellcare Medicare |
$4,314.22
|
|
|
CC REVISE POCKET, SC/DC ICD
|
Facility
OP
|
$4,914.88
|
|
|
Service Code
|
HCPCS 33223
|
| Hospital Charge Code |
66528645
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$464.82 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,108.87
|
| Rate for Payer: Aetna Government |
$2,108.87
|
| Rate for Payer: Cash Price |
$2,108.87
|
| Rate for Payer: Cash Price |
$2,108.87
|
| Rate for Payer: Cash Price |
$2,108.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,108.87
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$2,108.87
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$464.82
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,792.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,876.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,108.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,876.89
|
| Rate for Payer: Group Health Inc Commercial |
$2,108.87
|
| Rate for Payer: Group Health Inc Medicare |
$2,108.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,457.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,108.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$516.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,792.54
|
| Rate for Payer: Healthfirst QHP |
$2,108.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,108.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,108.87
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,687.10
|
| Rate for Payer: Wellcare Medicare |
$2,003.43
|
|
|
CC R HRT ART/GRFT ANGIO
|
Facility
OP
|
$8,631.78
|
|
|
Service Code
|
HCPCS 93457 TC
|
| Hospital Charge Code |
66528897
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$984.95 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,747.48
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,315.89
|
| Rate for Payer: Aetna Government |
$4,315.89
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$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: Fidelis CHP/HARP/Medicaid |
$984.95
|
| Rate for Payer: Group Health Inc Commercial |
$4,315.89
|
| Rate for Payer: Group Health Inc Medicare |
$3,021.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,315.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,315.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,094.39
|
|
|
CC R HRT CATH CHD ABNL NT CNJ
|
Facility
OP
|
$8,926.00
|
|
|
Service Code
|
HCPCS 93594
|
| Hospital Charge Code |
66521516
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,014.62 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,909.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,768.27
|
| Rate for Payer: Aetna Government |
$3,768.27
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$3,768.27
|
| 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 Medicaid |
$4,463.00
|
| 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: Senior Whole Health 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
|
|
|
CC R HRT CATH CHD NML NT CNJ
|
Facility
OP
|
$8,926.00
|
|
|
Service Code
|
HCPCS 93593
|
| Hospital Charge Code |
66521515
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,014.62 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,909.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,768.27
|
| Rate for Payer: Aetna Government |
$3,768.27
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$3,768.27
|
| 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 Medicaid |
$4,463.00
|
| 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: Senior Whole Health 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
|
|
|
CC R HRT CORONARY ARTERY ANGIO
|
Facility
OP
|
$8,631.78
|
|
|
Service Code
|
HCPCS 93456 TC
|
| Hospital Charge Code |
66528896
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$914.36 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,747.48
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,315.89
|
| Rate for Payer: Aetna Government |
$4,315.89
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$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: Fidelis CHP/HARP/Medicaid |
$914.36
|
| Rate for Payer: Group Health Inc Commercial |
$4,315.89
|
| Rate for Payer: Group Health Inc Medicare |
$3,021.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,315.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,315.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,015.95
|
|
|
CC RIGHT HEART CATH
|
Facility
OP
|
$8,631.78
|
|
|
Service Code
|
HCPCS 93451 TC
|
| Hospital Charge Code |
66528892
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$821.57 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,747.48
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,315.89
|
| Rate for Payer: Aetna Government |
$4,315.89
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$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: Fidelis CHP/HARP/Medicaid |
$821.57
|
| Rate for Payer: Group Health Inc Commercial |
$4,315.89
|
| Rate for Payer: Group Health Inc Medicare |
$3,021.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,315.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,315.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$912.86
|
|
|
CC R&L HRT ART/GRAFT/VENTRICLE AN
|
Facility
OP
|
$8,631.78
|
|
|
Service Code
|
HCPCS 93461 TC
|
| Hospital Charge Code |
66528899
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,075.82 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,747.48
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,315.89
|
| Rate for Payer: Aetna Government |
$4,315.89
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$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: Fidelis CHP/HARP/Medicaid |
$1,075.82
|
| Rate for Payer: Group Health Inc Commercial |
$4,315.89
|
| Rate for Payer: Group Health Inc Medicare |
$3,021.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,315.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,315.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,195.35
|
|
|
CC R&L HRT ART/VENTRICLE ANGIO
|
Facility
OP
|
$8,631.78
|
|
|
Service Code
|
HCPCS 93460 TC
|
| Hospital Charge Code |
66528898
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$975.71 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,747.48
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,315.89
|
| Rate for Payer: Aetna Government |
$4,315.89
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$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: Fidelis CHP/HARP/Medicaid |
$975.71
|
| Rate for Payer: Group Health Inc Commercial |
$4,315.89
|
| Rate for Payer: Group Health Inc Medicare |
$3,021.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,315.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,315.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,084.12
|
|
|
CC R&L HRT CATH CHD ABNL NT CNJ
|
Facility
OP
|
$8,926.00
|
|
|
Service Code
|
HCPCS 93597
|
| Hospital Charge Code |
66521519
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,014.62 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,909.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,768.27
|
| Rate for Payer: Aetna Government |
$3,768.27
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$3,768.27
|
| 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 Medicaid |
$4,463.00
|
| 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: Senior Whole Health 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
|
|
|
CC R&L HRT CATH CHD NML NT CNJ
|
Facility
OP
|
$8,926.00
|
|
|
Service Code
|
HCPCS 93596
|
| Hospital Charge Code |
66521518
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,014.62 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,909.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,768.27
|
| Rate for Payer: Aetna Government |
$3,768.27
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$3,768.27
|
| 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 Medicaid |
$4,463.00
|
| 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: Senior Whole Health 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
|
|
|
CC R&L HRT CATH W/VENTRICLGRPHY
|
Facility
OP
|
$8,631.78
|
|
|
Service Code
|
HCPCS 93453 TC
|
| Hospital Charge Code |
66528893
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$931.36 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,747.48
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,315.89
|
| Rate for Payer: Aetna Government |
$4,315.89
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$3,768.27
|
| Rate for Payer: Cash Price |
$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: Fidelis CHP/HARP/Medicaid |
$931.36
|
| Rate for Payer: Group Health Inc Commercial |
$4,315.89
|
| Rate for Payer: Group Health Inc Medicare |
$3,021.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,315.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,315.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,034.84
|
|
|
CC SAFE SHEATH 9 FR TEAR-AWAY VLV
|
Facility
IP
|
$78.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
66526878
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$39.00 |
| Max. Negotiated Rate |
$39.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$39.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$39.00
|
|
|
CC SAFE SHEATH 9 FR TEAR-AWAY VLV
|
Facility
OP
|
$78.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
66526878
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$81.90 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$42.90
|
| 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 |
$39.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$44.85
|
| Rate for Payer: Fidelis Medicare Advantage |
$81.90
|
| Rate for Payer: Group Health Inc Commercial |
$39.00
|
| Rate for Payer: Group Health Inc Medicare |
$27.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$39.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$39.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$50.70
|
|
|
CC SAFESHEATH TEAR AWAY
|
Facility
IP
|
$75.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
66526882
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$37.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$37.50
|
|
|
CC SAFESHEATH TEAR AWAY
|
Facility
OP
|
$75.00
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
66526882
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$78.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$41.25
|
| 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 |
$37.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$43.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$78.75
|
| Rate for Payer: Group Health Inc Commercial |
$37.50
|
| Rate for Payer: Group Health Inc Medicare |
$26.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$37.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$37.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$48.75
|
|
|
CC SC/DC ICD GENERATOR CHANGE
|
Facility
OP
|
$68,791.68
|
|
|
Service Code
|
HCPCS 33240
|
| Hospital Charge Code |
66528644
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$416.14 |
| Max. Negotiated Rate |
$44,507.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$44,507.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$27,258.51
|
| Rate for Payer: Aetna Government |
$27,258.51
|
| Rate for Payer: Cash Price |
$27,258.51
|
| Rate for Payer: Cash Price |
$27,258.51
|
| Rate for Payer: Cash Price |
$27,258.51
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$27,258.51
|
| 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 |
$27,258.51
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$416.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$23,169.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$24,260.07
|
| Rate for Payer: Fidelis Medicare Advantage |
$27,258.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24,260.07
|
| Rate for Payer: Group Health Inc Commercial |
$27,258.51
|
| Rate for Payer: Group Health Inc Medicare |
$27,258.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34,395.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$27,258.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$462.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$23,169.73
|
| Rate for Payer: Healthfirst QHP |
$27,258.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$27,258.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$27,258.51
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$21,806.81
|
| Rate for Payer: Wellcare Medicare |
$25,895.58
|
|
|
CC SCOPE EXAM OF LUNG, AIRWAY
|
Facility
OP
|
$4,535.55
|
|
|
Service Code
|
HCPCS 31623
|
| Hospital Charge Code |
66521558
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$136.77 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,962.76
|
| Rate for Payer: Aetna Government |
$1,962.76
|
| Rate for Payer: Cash Price |
$1,962.76
|
| Rate for Payer: Cash Price |
$1,962.76
|
| Rate for Payer: Cash Price |
$1,962.76
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,962.76
|
| 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 |
$1,962.76
|
| Rate for Payer: EmblemHealth Commercial |
$1,962.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$136.77
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,668.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,746.86
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,962.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,746.86
|
| Rate for Payer: Group Health Inc Commercial |
$1,962.76
|
| Rate for Payer: Group Health Inc Medicare |
$1,962.76
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,267.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,962.76
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$151.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,668.35
|
| Rate for Payer: Healthfirst QHP |
$1,962.76
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,962.76
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,962.76
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,570.21
|
| Rate for Payer: Wellcare Medicare |
$1,864.62
|
|
