|
HC BRONCHOSCOPE ASSIST
|
Facility
|
OP
|
$421.00
|
|
|
Service Code
|
CPT 94799 TC
|
| Hospital Charge Code |
4609479903
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$147.35 |
| Max. Negotiated Rate |
$336.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$231.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$210.50
|
| Rate for Payer: Aetna Government |
$210.50
|
| Rate for Payer: Brighton Health Commercial |
$315.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$336.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$286.28
|
| Rate for Payer: EmblemHealth Commercial |
$210.50
|
| Rate for Payer: Group Health Inc Commercial |
$210.50
|
| Rate for Payer: Group Health Inc Medicare |
$147.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$210.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$210.50
|
| Rate for Payer: United Healthcare Commercial |
$210.50
|
|
|
HC BRONCHOSCOPE ASSIST
|
Facility
|
IP
|
$421.00
|
|
|
Service Code
|
CPT 94799 TC
|
| Hospital Charge Code |
4609479903
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$210.50 |
| Max. Negotiated Rate |
$210.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$210.50
|
|
|
HC BRONCHOSCOPY BALLOON OCCLUSION
|
Facility
|
IP
|
$18,556.00
|
|
|
Service Code
|
CPT 31634
|
| Hospital Charge Code |
3613163401
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,278.00 |
| Max. Negotiated Rate |
$9,278.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9,278.00
|
|
|
HC BRONCHOSCOPY BALLOON OCCLUSION
|
Facility
|
OP
|
$18,556.00
|
|
|
Service Code
|
CPT 31634
|
| Hospital Charge Code |
3613163401
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$207.79 |
| Max. Negotiated Rate |
$13,917.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8,458.01
|
| Rate for Payer: Aetna Government |
$8,458.01
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5,920.61
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5,920.61
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5,920.61
|
| Rate for Payer: Brighton Health Commercial |
$13,917.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8,458.01
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$8,458.01
|
| Rate for Payer: EmblemHealth Commercial |
$8,458.01
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7,612.21
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7,189.31
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7,527.63
|
| Rate for Payer: Fidelis Medicare Advantage |
$8,458.01
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7,527.63
|
| Rate for Payer: Group Health Inc Commercial |
$8,458.01
|
| Rate for Payer: Group Health Inc Medicare |
$8,458.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8,458.01
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,425.84
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$207.79
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,189.31
|
| Rate for Payer: Healthfirst QHP |
$8,458.01
|
| Rate for Payer: Humana Medicare |
$8,627.17
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8,458.01
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,458.01
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8,458.01
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8,035.11
|
| Rate for Payer: Wellcare Medicare |
$8,035.11
|
|
|
HC BRONCHOSCOPY,BIOPSY
|
Facility
|
OP
|
$4,535.00
|
|
|
Service Code
|
CPT 31625
|
| Hospital Charge Code |
3613162502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$170.87 |
| Max. Negotiated Rate |
$3,401.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,106.99
|
| Rate for Payer: Aetna Government |
$2,106.99
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,474.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,474.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,474.89
|
| Rate for Payer: Brighton Health Commercial |
$3,401.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,106.99
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$2,106.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,106.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,896.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,790.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,875.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,106.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,875.22
|
| Rate for Payer: Group Health Inc Commercial |
$2,106.99
|
| Rate for Payer: Group Health Inc Medicare |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$792.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$170.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,790.94
|
| Rate for Payer: Healthfirst QHP |
$2,106.99
|
| Rate for Payer: Humana Medicare |
$2,149.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,106.99
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,106.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,106.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,001.64
|
| Rate for Payer: Wellcare Medicare |
$2,001.64
|
|
|
HC BRONCHOSCOPY,BIOPSY
|
Facility
|
OP
|
$4,535.00
|
|
|
Service Code
|
CPT 31625
|
| Hospital Charge Code |
3613162501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$170.87 |
| Max. Negotiated Rate |
$3,401.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,106.99
|
| Rate for Payer: Aetna Government |
$2,106.99
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,474.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,474.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,474.89
|
| Rate for Payer: Brighton Health Commercial |
$3,401.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,106.99
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$2,106.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,106.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,896.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,790.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,875.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,106.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,875.22
|
| Rate for Payer: Group Health Inc Commercial |
$2,106.99
|
| Rate for Payer: Group Health Inc Medicare |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$792.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$170.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,790.94
|
| Rate for Payer: Healthfirst QHP |
$2,106.99
|
| Rate for Payer: Humana Medicare |
$2,149.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,106.99
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,106.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,106.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,001.64
|
| Rate for Payer: Wellcare Medicare |
$2,001.64
|
|
|
HC BRONCHOSCOPY,BIOPSY
|
Facility
|
IP
|
$4,535.00
|
|
|
Service Code
|
CPT 31625
|
| Hospital Charge Code |
3613162501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,267.50 |
| Max. Negotiated Rate |
$2,267.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,267.50
|
|
|
HC BRONCHOSCOPY,BIOPSY
|
Facility
|
IP
|
$4,535.00
|
|
|
Service Code
|
CPT 31625
|
| Hospital Charge Code |
3613162502
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,267.50 |
| Max. Negotiated Rate |
$2,267.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,267.50
|
|
|
HC BRONCHOSCOPY,DIAGNOSTIC
|
Facility
|
OP
|
$4,535.00
|
|
|
Service Code
|
CPT 31622
|
| Hospital Charge Code |
3613162202
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$147.00 |
| Max. Negotiated Rate |
$3,401.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,106.99
|
| Rate for Payer: Aetna Government |
$2,106.99
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,474.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,474.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,474.89
|
| Rate for Payer: Brighton Health Commercial |
$3,401.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,106.99
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$2,106.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,106.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,896.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,790.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,875.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,106.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,875.22
|
| Rate for Payer: Group Health Inc Commercial |
$2,106.99
|
| Rate for Payer: Group Health Inc Medicare |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$792.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$147.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,790.94
|
| Rate for Payer: Healthfirst QHP |
$2,106.99
|
| Rate for Payer: Humana Medicare |
$2,149.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,106.99
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,106.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,106.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,001.64
|
| Rate for Payer: Wellcare Medicare |
$2,001.64
|
|
|
HC BRONCHOSCOPY,DIAGNOSTIC
|
Facility
|
IP
|
$4,535.00
|
|
|
Service Code
|
CPT 31622
|
| Hospital Charge Code |
3613162202
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,267.50 |
| Max. Negotiated Rate |
$2,267.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,267.50
|
|
|
HC BRONCHOSCOPY,DIAGNOSTIC W BRUSH
|
Facility
|
IP
|
$4,535.00
|
|
|
Service Code
|
CPT 31623
|
| Hospital Charge Code |
3613162301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,267.50 |
| Max. Negotiated Rate |
$2,267.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,267.50
|
|
|
HC BRONCHOSCOPY,DIAGNOSTIC W BRUSH
|
Facility
|
OP
|
$4,535.00
|
|
|
Service Code
|
CPT 31623
|
| Hospital Charge Code |
3613162301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$144.41 |
| Max. Negotiated Rate |
$3,401.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,106.99
|
| Rate for Payer: Aetna Government |
$2,106.99
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,474.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,474.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,474.89
|
| Rate for Payer: Brighton Health Commercial |
$3,401.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,106.99
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$2,106.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,106.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,896.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,790.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,875.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,106.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,875.22
|
| Rate for Payer: Group Health Inc Commercial |
$2,106.99
|
| Rate for Payer: Group Health Inc Medicare |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$792.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$144.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,790.94
|
| Rate for Payer: Healthfirst QHP |
$2,106.99
|
| Rate for Payer: Humana Medicare |
$2,149.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,106.99
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,106.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,106.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,001.64
|
| Rate for Payer: Wellcare Medicare |
$2,001.64
|
|
|
HC BRONCHOSCOPY,DIAGNOSTIC W BRUSH
|
Facility
|
OP
|
$4,535.00
|
|
|
Service Code
|
CPT 31622
|
| Hospital Charge Code |
3613162201
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$147.00 |
| Max. Negotiated Rate |
$3,401.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,106.99
|
| Rate for Payer: Aetna Government |
$2,106.99
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,474.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,474.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,474.89
|
| Rate for Payer: Brighton Health Commercial |
$3,401.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,106.99
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$2,106.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,106.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,896.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,790.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,875.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,106.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,875.22
|
| Rate for Payer: Group Health Inc Commercial |
$2,106.99
|
| Rate for Payer: Group Health Inc Medicare |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$792.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$147.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,790.94
|
| Rate for Payer: Healthfirst QHP |
$2,106.99
|
| Rate for Payer: Humana Medicare |
$2,149.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,106.99
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,106.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,106.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,001.64
|
| Rate for Payer: Wellcare Medicare |
$2,001.64
|
|
|
HC BRONCHOSCOPY,DIAGNOSTIC W BRUSH
|
Facility
|
IP
|
$4,535.00
|
|
|
Service Code
|
CPT 31622
|
| Hospital Charge Code |
3613162201
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,267.50 |
| Max. Negotiated Rate |
$2,267.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,267.50
|
|
|
HC BRONCHOSCOPY,DIAGNOSTIC W BRUSH
|
Facility
|
OP
|
$4,535.00
|
|
|
Service Code
|
CPT 31623
|
| Hospital Charge Code |
3613162302
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$144.41 |
| Max. Negotiated Rate |
$3,401.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,106.99
|
| Rate for Payer: Aetna Government |
$2,106.99
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,474.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,474.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,474.89
|
| Rate for Payer: Brighton Health Commercial |
$3,401.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,106.99
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$2,106.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,106.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,896.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,790.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,875.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,106.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,875.22
|
| Rate for Payer: Group Health Inc Commercial |
$2,106.99
|
| Rate for Payer: Group Health Inc Medicare |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$792.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$144.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,790.94
|
| Rate for Payer: Healthfirst QHP |
$2,106.99
|
| Rate for Payer: Humana Medicare |
$2,149.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,106.99
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,106.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,106.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,001.64
|
| Rate for Payer: Wellcare Medicare |
$2,001.64
|
|
|
HC BRONCHOSCOPY,DIAGNOSTIC W BRUSH
|
Facility
|
IP
|
$4,535.00
|
|
|
Service Code
|
CPT 31623
|
| Hospital Charge Code |
3613162302
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,267.50 |
| Max. Negotiated Rate |
$2,267.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,267.50
|
|
|
HC BRONCHOSCOPY,DIAGNOSTIC W LAVAGE
|
Facility
|
OP
|
$4,794.00
|
|
|
Service Code
|
CPT 31624
|
| Hospital Charge Code |
3613162401
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$146.97 |
| Max. Negotiated Rate |
$3,595.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,106.99
|
| Rate for Payer: Aetna Government |
$2,106.99
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,474.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,474.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,474.89
|
| Rate for Payer: Brighton Health Commercial |
$3,595.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,106.99
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$2,106.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,106.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,896.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,790.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,875.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,106.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,875.22
|
| Rate for Payer: Group Health Inc Commercial |
$2,106.99
|
| Rate for Payer: Group Health Inc Medicare |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$792.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$146.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,790.94
|
| Rate for Payer: Healthfirst QHP |
$2,106.99
|
| Rate for Payer: Humana Medicare |
$2,149.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,106.99
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,106.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,106.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,001.64
|
| Rate for Payer: Wellcare Medicare |
$2,001.64
|
|
|
HC BRONCHOSCOPY,DIAGNOSTIC W LAVAGE
|
Facility
|
IP
|
$4,794.00
|
|
|
Service Code
|
CPT 31624
|
| Hospital Charge Code |
3613162401
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,397.00 |
| Max. Negotiated Rate |
$2,397.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,397.00
|
|
|
HC BRONCHOSCOPY,REMV FOR. BODY
|
Facility
|
IP
|
$4,794.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
3613163501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,397.00 |
| Max. Negotiated Rate |
$2,397.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,397.00
|
|
|
HC BRONCHOSCOPY,REMV FOR. BODY
|
Facility
|
OP
|
$4,794.00
|
|
|
Service Code
|
CPT 31635
|
| Hospital Charge Code |
3613163501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$193.63 |
| Max. Negotiated Rate |
$3,595.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,106.99
|
| Rate for Payer: Aetna Government |
$2,106.99
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,474.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,474.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,474.89
|
| Rate for Payer: Brighton Health Commercial |
$3,595.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,106.99
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$2,106.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,106.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,896.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,790.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,875.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,106.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,875.22
|
| Rate for Payer: Group Health Inc Commercial |
$2,106.99
|
| Rate for Payer: Group Health Inc Medicare |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$792.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$193.63
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,790.94
|
| Rate for Payer: Healthfirst QHP |
$2,106.99
|
| Rate for Payer: Humana Medicare |
$2,149.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,106.99
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,106.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,106.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,001.64
|
| Rate for Payer: Wellcare Medicare |
$2,001.64
|
|
|
HC BRONCHOSCOPY,RX W PLACE CATHETER
|
Facility
|
OP
|
$4,042.00
|
|
|
Service Code
|
CPT 31643
|
| Hospital Charge Code |
3613164301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$184.50 |
| Max. Negotiated Rate |
$3,092.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,106.99
|
| Rate for Payer: Aetna Government |
$2,106.99
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,474.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,474.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,474.89
|
| Rate for Payer: Brighton Health Commercial |
$3,031.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,106.99
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$2,106.99
|
| Rate for Payer: EmblemHealth Commercial |
$2,106.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,896.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,790.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,875.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,106.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,875.22
|
| Rate for Payer: Group Health Inc Commercial |
$2,106.99
|
| Rate for Payer: Group Health Inc Medicare |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,106.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$792.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$184.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,790.94
|
| Rate for Payer: Healthfirst QHP |
$2,106.99
|
| Rate for Payer: Humana Medicare |
$2,149.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,106.99
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2,106.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,106.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,001.64
|
| Rate for Payer: Wellcare Medicare |
$2,001.64
|
|
|
HC BRONCHOSCOPY,RX W PLACE CATHETER
|
Facility
|
IP
|
$4,042.00
|
|
|
Service Code
|
CPT 31643
|
| Hospital Charge Code |
3613164301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,021.00 |
| Max. Negotiated Rate |
$2,021.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,021.00
|
|
|
HC BRONCHOSCOPY,TRACH DIL+STENT
|
Facility
|
OP
|
$16,477.00
|
|
|
Service Code
|
CPT 31631 TC
|
| Hospital Charge Code |
3613163101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$242.79 |
| Max. Negotiated Rate |
$12,357.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$242.79
|
| Rate for Payer: Aetna Government |
$242.79
|
| Rate for Payer: Brighton Health Commercial |
$12,357.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: EmblemHealth Commercial |
$8,238.50
|
| Rate for Payer: Group Health Inc Commercial |
$8,238.50
|
| Rate for Payer: Group Health Inc Medicare |
$5,766.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8,238.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,425.84
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
|
|
HC BRONCHOSCOPY,TRACH DIL+STENT
|
Facility
|
IP
|
$16,477.00
|
|
|
Service Code
|
CPT 31631 TC
|
| Hospital Charge Code |
3613163101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,238.50 |
| Max. Negotiated Rate |
$8,238.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8,238.50
|
|
|
HC BRONCHOSCOPY,TRANSBRON ASPIR BX
|
Facility
|
IP
|
$8,895.00
|
|
|
Service Code
|
CPT 31629
|
| Hospital Charge Code |
3613162901
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,447.50 |
| Max. Negotiated Rate |
$4,447.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,447.50
|
|
