|
CC EMBOLIC A.C. V.S PRONTO LP
|
Facility
|
IP
|
$990.00
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
66522019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$495.00 |
| Max. Negotiated Rate |
$495.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$495.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$495.00
|
|
|
CC EMBOLIC A.C. V.S PRONTO LP
|
Facility
|
OP
|
$990.00
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
66522019
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16.33 |
| Max. Negotiated Rate |
$1,039.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$544.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16.33
|
| Rate for Payer: Aetna Government |
$16.33
|
| Rate for Payer: Brighton Health Commercial |
$594.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$495.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$569.25
|
| Rate for Payer: EmblemHealth Commercial |
$495.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,039.50
|
| Rate for Payer: Group Health Inc Commercial |
$495.00
|
| Rate for Payer: Group Health Inc Medicare |
$346.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$495.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$495.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$643.50
|
|
|
CC ENDOMYOCARDIAL BIOPSY
|
Facility
|
OP
|
$8,393.53
|
|
|
Service Code
|
HCPCS 93505 TC
|
| Hospital Charge Code |
66528201
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,835.00 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,616.44
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,686.08
|
| Rate for Payer: Aetna Government |
$3,686.08
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,580.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,580.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,580.26
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| 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 |
$4,959.74
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4,215.78
|
| Rate for Payer: Elderplan Medicare Advantage |
$3,686.08
|
| Rate for Payer: EmblemHealth Commercial |
$3,686.08
|
| 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 Medicare Advantage |
$3,133.17
|
| Rate for Payer: Healthfirst QHP |
$3,686.08
|
| Rate for Payer: Humana Medicare |
$3,759.80
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,686.08
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare 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 ENDOMYOCARDIAL BIOPSY
|
Facility
|
IP
|
$8,393.53
|
|
|
Service Code
|
HCPCS 93505 TC
|
| Hospital Charge Code |
66528201
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$3,686.08
|
|
|
CC EP EVAL CD, W GENERATOR TEST
|
Facility
|
OP
|
$947.20
|
|
|
Service Code
|
HCPCS 93641 26
|
| Hospital Charge Code |
66528664
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$273.15 |
| Max. Negotiated Rate |
$757.76 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$520.96
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$273.15
|
| Rate for Payer: Aetna Government |
$273.15
|
| Rate for Payer: Brighton Health Commercial |
$710.40
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$757.76
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$644.10
|
| Rate for Payer: Group Health Inc Commercial |
$473.60
|
| Rate for Payer: Group Health Inc Medicare |
$331.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$473.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$473.60
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
|
|
CC EP EVAL CD, W PACING
|
Facility
|
OP
|
$2,991.08
|
|
|
Service Code
|
HCPCS 93642 26
|
| Hospital Charge Code |
66528665
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$316.00 |
| Max. Negotiated Rate |
$2,392.86 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,645.09
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,376.30
|
| Rate for Payer: Aetna Government |
$1,376.30
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$963.41
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$963.41
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$963.41
|
| Rate for Payer: Brighton Health Commercial |
$2,243.31
|
| Rate for Payer: Cash Price |
$1,376.30
|
| Rate for Payer: Cash Price |
$1,376.30
|
| Rate for Payer: Cash Price |
$1,376.30
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,376.30
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,392.86
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,033.93
|
| Rate for Payer: Elderplan Medicare Advantage |
$1,376.30
|
| Rate for Payer: EmblemHealth Commercial |
$1,376.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,169.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,224.91
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,376.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,224.91
|
| Rate for Payer: Group Health Inc Commercial |
$1,376.30
|
| Rate for Payer: Group Health Inc Medicare |
$1,376.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,495.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,376.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,169.86
|
| Rate for Payer: Healthfirst QHP |
$1,376.30
|
| Rate for Payer: Humana Medicare |
$1,403.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,376.30
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,376.30
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,376.30
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,101.04
|
| Rate for Payer: Wellcare Medicare |
$1,307.48
|
|
|
CC EP EVAL CD, W PACING
|
Facility
|
IP
|
$2,991.08
|
|
|
Service Code
|
HCPCS 93642 26
|
| Hospital Charge Code |
66528665
|
|
Hospital Revenue Code
|
480
|
| Rate for Payer: Cash Price |
$1,376.30
|
|
|
CC ESOPH ATRIAL ELECTROGRAM
|
Facility
|
OP
|
$2,991.08
|
|
|
Service Code
|
HCPCS 93615 26
|
| Hospital Charge Code |
66528674
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$316.00 |
| Max. Negotiated Rate |
$2,392.86 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,645.09
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,376.30
|
| Rate for Payer: Aetna Government |
$1,376.30
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$963.41
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$963.41
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$963.41
|
| Rate for Payer: Brighton Health Commercial |
$2,243.31
|
| Rate for Payer: Cash Price |
$1,376.30
|
| Rate for Payer: Cash Price |
$1,376.30
|
| Rate for Payer: Cash Price |
$1,376.30
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,376.30
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,392.86
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,033.93
|
| Rate for Payer: Elderplan Medicare Advantage |
$1,376.30
|
| Rate for Payer: EmblemHealth Commercial |
$1,376.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,169.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,224.91
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,376.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,224.91
|
| Rate for Payer: Group Health Inc Commercial |
$1,376.30
|
| Rate for Payer: Group Health Inc Medicare |
$1,376.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,495.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,376.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,169.86
|
| Rate for Payer: Healthfirst QHP |
$1,376.30
|
| Rate for Payer: Humana Medicare |
$1,403.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,376.30
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,376.30
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,376.30
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,101.04
|
| Rate for Payer: Wellcare Medicare |
$1,307.48
|
|
|
CC ESOPH ATRIAL ELECTROGRAM
|
Facility
|
IP
|
$2,991.08
|
|
|
Service Code
|
HCPCS 93615 26
|
| Hospital Charge Code |
66528674
|
|
Hospital Revenue Code
|
480
|
| Rate for Payer: Cash Price |
$1,376.30
|
|
|
CC ESOPH ATRIAL ELECTROGR, W PACI
|
Facility
|
OP
|
$2,991.08
|
|
|
Service Code
|
HCPCS 93616 26
|
| Hospital Charge Code |
66528675
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$316.00 |
| Max. Negotiated Rate |
$2,392.86 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,645.09
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,376.30
|
| Rate for Payer: Aetna Government |
$1,376.30
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$963.41
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$963.41
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$963.41
|
| Rate for Payer: Brighton Health Commercial |
$2,243.31
|
| Rate for Payer: Cash Price |
$1,376.30
|
| Rate for Payer: Cash Price |
$1,376.30
|
| Rate for Payer: Cash Price |
$1,376.30
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,376.30
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,392.86
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,033.93
|
| Rate for Payer: Elderplan Medicare Advantage |
$1,376.30
|
| Rate for Payer: EmblemHealth Commercial |
$1,376.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,169.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,224.91
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,376.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,224.91
|
| Rate for Payer: Group Health Inc Commercial |
$1,376.30
|
| Rate for Payer: Group Health Inc Medicare |
$1,376.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,495.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,376.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,169.86
|
| Rate for Payer: Healthfirst QHP |
$1,376.30
|
| Rate for Payer: Humana Medicare |
$1,403.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,376.30
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,376.30
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,376.30
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,101.04
|
| Rate for Payer: Wellcare Medicare |
$1,307.48
|
|
|
CC ESOPH ATRIAL ELECTROGR, W PACI
|
Facility
|
IP
|
$2,991.08
|
|
|
Service Code
|
HCPCS 93616 26
|
| Hospital Charge Code |
66528675
|
|
Hospital Revenue Code
|
480
|
| Rate for Payer: Cash Price |
$1,376.30
|
|
|
CC EXERCISE W/HEMODYNAMIC MEAS
|
Facility
|
OP
|
$772.35
|
|
|
Service Code
|
HCPCS 93464 TC
|
| Hospital Charge Code |
66528902
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$168.14 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$424.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$168.14
|
| Rate for Payer: Aetna Government |
$168.14
|
| 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 |
$386.18
|
| Rate for Payer: Group Health Inc Medicare |
$270.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$386.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$386.18
|
| Rate for Payer: United Healthcare Commercial |
$1,113.00
|
|
|
CC EXOSEAL VASC CLOSE DEVICE 5F
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
66526867
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$73.50 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$123.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$73.50
|
| Rate for Payer: Aetna Government |
$73.50
|
| Rate for Payer: Brighton Health Commercial |
$135.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$112.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$129.38
|
| Rate for Payer: EmblemHealth Commercial |
$112.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$236.25
|
| Rate for Payer: Group Health Inc Commercial |
$112.50
|
| Rate for Payer: Group Health Inc Medicare |
$78.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$112.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$112.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$146.25
|
|
|
CC EXOSEAL VASC CLOSE DEVICE 5F
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
66526867
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$112.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$112.50
|
|
|
CC EXOSEAL VASC CLOSE DEVICE 6F
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
66526868
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$73.50 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$123.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$73.50
|
| Rate for Payer: Aetna Government |
$73.50
|
| Rate for Payer: Brighton Health Commercial |
$135.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$112.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$129.38
|
| Rate for Payer: EmblemHealth Commercial |
$112.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$236.25
|
| Rate for Payer: Group Health Inc Commercial |
$112.50
|
| Rate for Payer: Group Health Inc Medicare |
$78.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$112.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$112.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$146.25
|
|
|
CC EXOSEAL VASC CLOSE DEVICE 6F
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
66526868
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$112.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$112.50
|
|
|
CC EXOSEAL VASC CLOSE DEVICE 7F
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
66526869
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$112.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$112.50
|
|
|
CC EXOSEAL VASC CLOSE DEVICE 7F
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
66526869
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$73.50 |
| Max. Negotiated Rate |
$236.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$123.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$73.50
|
| Rate for Payer: Aetna Government |
$73.50
|
| Rate for Payer: Brighton Health Commercial |
$135.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$112.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$129.38
|
| Rate for Payer: EmblemHealth Commercial |
$112.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$236.25
|
| Rate for Payer: Group Health Inc Commercial |
$112.50
|
| Rate for Payer: Group Health Inc Medicare |
$78.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$112.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$112.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$146.25
|
|
|
CC EXTREM VENOGRAM INJ
|
Facility
|
OP
|
$1,032.38
|
|
|
Service Code
|
HCPCS 36005
|
| Hospital Charge Code |
66528655
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$52.98 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$52.98
|
| Rate for Payer: Aetna Government |
$52.98
|
| Rate for Payer: Brighton Health Commercial |
$774.28
|
| 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: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Group Health Inc Commercial |
$516.19
|
| Rate for Payer: Group Health Inc Medicare |
$361.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$516.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$516.19
|
| Rate for Payer: United Healthcare Commercial |
$1,113.00
|
|
|
CC FIBEROPTIC BRONCH SWIVEL ADAPT
|
Facility
|
OP
|
$500.00
|
|
| Hospital Charge Code |
66571552
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$400.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$275.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$250.00
|
| Rate for Payer: Aetna Government |
$250.00
|
| Rate for Payer: Brighton Health Commercial |
$375.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$400.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$340.00
|
| Rate for Payer: Group Health Inc Commercial |
$250.00
|
| Rate for Payer: Group Health Inc Medicare |
$175.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$250.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$250.00
|
|
|
CC FLUOROSCOPE EXAM EXTENSIVE 1+
|
Facility
|
OP
|
$705.83
|
|
|
Service Code
|
HCPCS 76000 TC
|
| Hospital Charge Code |
66520312
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$141.40 |
| Max. Negotiated Rate |
$388.21 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$388.21
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$283.37
|
| Rate for Payer: Aetna Government |
$283.37
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$198.36
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$198.36
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$198.36
|
| Rate for Payer: Brighton Health Commercial |
$283.37
|
| Rate for Payer: Cash Price |
$283.37
|
| Rate for Payer: Cash Price |
$283.37
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$283.37
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$167.12
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$141.40
|
| Rate for Payer: Elderplan Medicare Advantage |
$283.37
|
| Rate for Payer: EmblemHealth Commercial |
$198.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$240.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$240.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$252.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$283.37
|
| Rate for Payer: Fidelis Qualified Health Plan |
$252.20
|
| Rate for Payer: Group Health Inc Commercial |
$255.03
|
| Rate for Payer: Group Health Inc Medicare |
$255.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$352.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$283.37
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$255.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$283.37
|
| Rate for Payer: Healthfirst QHP |
$283.37
|
| Rate for Payer: Humana Medicare |
$289.04
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$283.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$283.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$283.37
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$226.70
|
| Rate for Payer: Wellcare Medicare |
$269.20
|
|
|
CC FLUOROSCOPE EXAM EXTENSIVE 1+
|
Facility
|
IP
|
$705.83
|
|
|
Service Code
|
HCPCS 76000 TC
|
| Hospital Charge Code |
66520312
|
|
Hospital Revenue Code
|
320
|
| Rate for Payer: Cash Price |
$283.37
|
|
|
CC FLUOROSCOPE EXAMINATION =< 1 H
|
Facility
|
IP
|
$705.83
|
|
|
Service Code
|
HCPCS 76000 TC
|
| Hospital Charge Code |
66520311
|
|
Hospital Revenue Code
|
320
|
| Rate for Payer: Cash Price |
$283.37
|
|
|
CC FLUOROSCOPE EXAMINATION =< 1 H
|
Facility
|
OP
|
$705.83
|
|
|
Service Code
|
HCPCS 76000 TC
|
| Hospital Charge Code |
66520311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$141.40 |
| Max. Negotiated Rate |
$388.21 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$388.21
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$283.37
|
| Rate for Payer: Aetna Government |
$283.37
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$198.36
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$198.36
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$198.36
|
| Rate for Payer: Brighton Health Commercial |
$283.37
|
| Rate for Payer: Cash Price |
$283.37
|
| Rate for Payer: Cash Price |
$283.37
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$283.37
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$167.12
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$141.40
|
| Rate for Payer: Elderplan Medicare Advantage |
$283.37
|
| Rate for Payer: EmblemHealth Commercial |
$198.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$240.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$240.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$252.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$283.37
|
| Rate for Payer: Fidelis Qualified Health Plan |
$252.20
|
| Rate for Payer: Group Health Inc Commercial |
$255.03
|
| Rate for Payer: Group Health Inc Medicare |
$255.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$352.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$283.37
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$255.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$283.37
|
| Rate for Payer: Healthfirst QHP |
$283.37
|
| Rate for Payer: Humana Medicare |
$289.04
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$283.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$283.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$283.37
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$226.70
|
| Rate for Payer: Wellcare Medicare |
$269.20
|
|
|
CC G/C AR I 7F MEDTRONIC LAUNCHER
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
HCPCS C1887
|
| Hospital Charge Code |
66528999
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3.21 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$56.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3.21
|
| Rate for Payer: Aetna Government |
$3.21
|
| Rate for Payer: Brighton Health Commercial |
$61.20
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$58.65
|
| Rate for Payer: EmblemHealth Commercial |
$51.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$107.10
|
| Rate for Payer: Group Health Inc Commercial |
$51.00
|
| Rate for Payer: Group Health Inc Medicare |
$35.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$66.30
|
|
