|
CC REP 2 TB ELECTRODES, DC PMKR/C
|
Facility
|
IP
|
$9,037.83
|
|
|
Service Code
|
HCPCS 33220
|
| Hospital Charge Code |
66528638
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,541.28
|
|
|
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 |
$1,505.00 |
| Max. Negotiated Rate |
$6,778.37 |
| 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: Affinity Essential Plan 1&2 |
$3,178.90
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,178.90
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,178.90
|
| Rate for Payer: Brighton Health Commercial |
$6,778.37
|
| 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 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 Medicare Advantage |
$3,860.09
|
| Rate for Payer: Healthfirst QHP |
$4,541.28
|
| Rate for Payer: Humana Medicare |
$4,632.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,541.28
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare 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 |
$1,505.00 |
| Max. Negotiated Rate |
$6,295.15 |
| 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: 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 |
$6,295.15
|
| 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 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 REPOSITION L VENTRIC LEAD
|
Facility
|
IP
|
$8,393.53
|
|
|
Service Code
|
HCPCS 33226
|
| Hospital Charge Code |
66528653
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,686.08
|
|
|
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 |
$1,505.00 |
| Max. Negotiated Rate |
$6,295.15 |
| 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: 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 |
$6,295.15
|
| 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 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 REPOSITION PACING-DEFIB LEAD
|
Facility
|
IP
|
$8,393.53
|
|
|
Service Code
|
HCPCS 33215
|
| Hospital Charge Code |
66528633
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,686.08
|
|
|
CC REP SGLE TV ELECTRODE,SCPMKR/C
|
Facility
|
IP
|
$9,037.83
|
|
|
Service Code
|
HCPCS 33218
|
| Hospital Charge Code |
66528637
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$4,541.28
|
|
|
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 |
$1,505.00 |
| Max. Negotiated Rate |
$6,778.37 |
| 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: Affinity Essential Plan 1&2 |
$3,178.90
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,178.90
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,178.90
|
| Rate for Payer: Brighton Health Commercial |
$6,778.37
|
| 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 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 Medicare Advantage |
$3,860.09
|
| Rate for Payer: Healthfirst QHP |
$4,541.28
|
| Rate for Payer: Humana Medicare |
$4,632.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,541.28
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare 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
|
IP
|
$4,914.88
|
|
|
Service Code
|
HCPCS 33223
|
| Hospital Charge Code |
66528645
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$2,108.87
|
|
|
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 |
$1,409.00 |
| Max. Negotiated Rate |
$3,686.16 |
| 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: Affinity Essential Plan 1&2 |
$1,476.21
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,476.21
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,476.21
|
| Rate for Payer: Brighton Health Commercial |
$3,686.16
|
| 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 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 Medicare Advantage |
$1,792.54
|
| Rate for Payer: Healthfirst QHP |
$2,108.87
|
| Rate for Payer: Humana Medicare |
$2,151.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,108.87
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare 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 |
$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: 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 |
$4,315.89
|
| 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
|
|
|
CC R HRT ART/GRFT ANGIO
|
Facility
|
IP
|
$8,631.78
|
|
|
Service Code
|
HCPCS 93457 TC
|
| Hospital Charge Code |
66528897
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$3,768.27
|
|
|
CC R HRT CATH CHD ABNL NT CNJ
|
Facility
|
IP
|
$8,926.00
|
|
|
Service Code
|
HCPCS 93594
|
| Hospital Charge Code |
66521516
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$3,768.27
|
|
|
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 |
$2,637.79 |
| 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: 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: 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: Humana Medicare |
$3,843.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,768.27
|
| 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
|
|
|
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 |
$2,637.79 |
| 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: 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: 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: Humana Medicare |
$3,843.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,768.27
|
| 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
|
|
|
CC R HRT CATH CHD NML NT CNJ
|
Facility
|
IP
|
$8,926.00
|
|
|
Service Code
|
HCPCS 93593
|
| Hospital Charge Code |
66521515
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$3,768.27
|
|
|
CC R HRT CORONARY ARTERY ANGIO
|
Facility
|
IP
|
$8,631.78
|
|
|
Service Code
|
HCPCS 93456 TC
|
| Hospital Charge Code |
66528896
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$3,768.27
|
|
|
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 |
$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: 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 |
$4,315.89
|
| 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
|
|
|
CC RIGHT HEART CATH
|
Facility
|
IP
|
$8,631.78
|
|
|
Service Code
|
HCPCS 93451 TC
|
| Hospital Charge Code |
66528892
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$3,768.27
|
|
|
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 |
$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: 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 |
$4,315.89
|
| 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
|
|
|
CC R&L HRT ART/GRAFT/VENTRICLE AN
|
Facility
|
IP
|
$8,631.78
|
|
|
Service Code
|
HCPCS 93461 TC
|
| Hospital Charge Code |
66528899
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$3,768.27
|
|
|
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 |
$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: 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 |
$4,315.89
|
| 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
|
|
|
CC R&L HRT ART/VENTRICLE ANGIO
|
Facility
|
IP
|
$8,631.78
|
|
|
Service Code
|
HCPCS 93460 TC
|
| Hospital Charge Code |
66528898
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$3,768.27
|
|
|
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 |
$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: 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 |
$4,315.89
|
| 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
|
|
|
CC R&L HRT CATH CHD ABNL NT CNJ
|
Facility
|
IP
|
$8,926.00
|
|
|
Service Code
|
HCPCS 93597
|
| Hospital Charge Code |
66521519
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$3,768.27
|
|
