|
ABDM PERITONEAL LAVAGE
|
Facility
|
IP
|
$2,380.35
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
40019635
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,048.28
|
|
|
ABDOMINAL BINDER
|
Facility
|
OP
|
$35.79
|
|
| Hospital Charge Code |
40207596
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.53 |
| Max. Negotiated Rate |
$28.63 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$19.68
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$17.90
|
| Rate for Payer: Aetna Government |
$17.90
|
| Rate for Payer: Brighton Health Commercial |
$26.84
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$28.63
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$24.34
|
| Rate for Payer: Group Health Inc Commercial |
$17.90
|
| Rate for Payer: Group Health Inc Medicare |
$12.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$17.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17.90
|
|
|
ABDOMINAL HYSTERECTOMY
|
Facility
|
OP
|
$3,068.24
|
|
|
Service Code
|
HCPCS 58150
|
| Hospital Charge Code |
40052180
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,073.88 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,687.53
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,267.60
|
| Rate for Payer: Aetna Government |
$1,267.60
|
| Rate for Payer: Brighton Health Commercial |
$2,301.18
|
| 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 |
$1,534.12
|
| Rate for Payer: Group Health Inc Medicare |
$1,073.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,534.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,534.12
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
|
|
Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 49083
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$733.80 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,048.28
|
| Rate for Payer: Aetna Government |
$1,048.28
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$733.80
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$733.80
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$733.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,048.28
|
| 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 |
$1,048.28
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$891.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$932.97
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,048.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$932.97
|
| Rate for Payer: Group Health Inc Commercial |
$1,048.28
|
| Rate for Payer: Group Health Inc Medicare |
$1,048.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,048.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$891.04
|
| Rate for Payer: Healthfirst QHP |
$1,048.28
|
| Rate for Payer: Humana Medicare |
$1,069.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,048.28
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,048.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,048.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$838.62
|
| Rate for Payer: Wellcare Medicare |
$995.87
|
|
|
Abdominal paracentesis (diagnostic or therapeutic); with imaging guidance
|
Facility
|
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 49083
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$733.80 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,048.28
|
| Rate for Payer: Aetna Government |
$1,048.28
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$733.80
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$733.80
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$733.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,048.28
|
| 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 |
$1,048.28
|
| Rate for Payer: EmblemHealth Commercial |
$1,048.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$891.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$932.97
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,048.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$932.97
|
| Rate for Payer: Group Health Inc Commercial |
$1,048.28
|
| Rate for Payer: Group Health Inc Medicare |
$1,048.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,048.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$891.04
|
| Rate for Payer: Healthfirst QHP |
$1,048.28
|
| Rate for Payer: Humana Medicare |
$1,069.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,048.28
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,048.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,048.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$838.62
|
| Rate for Payer: Wellcare Medicare |
$995.87
|
|
|
ABDOMINAL PARACENTESIS W/O GUIDE
|
Facility
|
IP
|
$2,380.35
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
30105548
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,048.28
|
|
|
ABDOMINAL PARACENTESIS W/O GUIDE
|
Facility
|
OP
|
$2,380.35
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
30105548
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,048.28
|
| Rate for Payer: Aetna Government |
$1,048.28
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$733.80
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$733.80
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$733.80
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$1,048.28
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$1,048.28
|
| Rate for Payer: Cash Price |
$1,048.28
|
| Rate for Payer: Cash Price |
$1,048.28
|
| Rate for Payer: Cash Price |
$1,048.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,048.28
|
| 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 |
$1,048.28
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$891.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$932.97
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,048.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$932.97
|
| Rate for Payer: Group Health Inc Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Medicare |
$525.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,190.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,048.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$1,048.28
|
| Rate for Payer: Humana Medicare |
$1,069.25
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,048.28
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,048.28
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,048.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,048.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$838.62
|
| Rate for Payer: Wellcare Medicare |
$995.87
|
|
|
ABDOMINAL PARACENTESIS W/O IMAGE
|
Facility
|
OP
|
$2,380.35
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
30105563
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,048.28
|
| Rate for Payer: Aetna Government |
$1,048.28
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$733.80
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$733.80
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$733.80
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$1,048.28
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$1,048.28
|
| Rate for Payer: Cash Price |
$1,048.28
|
| Rate for Payer: Cash Price |
$1,048.28
|
| Rate for Payer: Cash Price |
$1,048.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,048.28
|
| 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 |
$1,048.28
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$891.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$932.97
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,048.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$932.97
|
| Rate for Payer: Group Health Inc Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Medicare |
$525.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,190.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,048.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$1,048.28
|
| Rate for Payer: Humana Medicare |
$1,069.25
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,048.28
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,048.28
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,048.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,048.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$838.62
|
| Rate for Payer: Wellcare Medicare |
$995.87
|
|
|
ABDOMINAL PARACENTESIS W/O IMAGE
|
Facility
|
OP
|
$2,380.35
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
30305563
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,048.28
|
| Rate for Payer: Aetna Government |
$1,048.28
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$733.80
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$733.80
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$733.80
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$1,048.28
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$1,048.28
|
| Rate for Payer: Cash Price |
$1,048.28
|
| Rate for Payer: Cash Price |
$1,048.28
|
| Rate for Payer: Cash Price |
$1,048.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,048.28
|
| 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 |
$1,048.28
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$891.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$932.97
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,048.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$932.97
|
| Rate for Payer: Group Health Inc Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Medicare |
$525.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,190.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,048.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$1,048.28
|
| Rate for Payer: Humana Medicare |
$1,069.25
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,048.28
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,048.28
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,048.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,048.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$838.62
|
| Rate for Payer: Wellcare Medicare |
$995.87
|
|
|
ABDOMINAL PARACENTESIS W/O IMAGE
|
Facility
|
IP
|
$2,380.35
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
30105563
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,048.28
|
|
|
ABDOMINAL PARACENTESIS W/O IMAGE
|
Facility
|
IP
|
$2,380.35
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
30305563
|
|
Hospital Revenue Code
|
450
|
| Rate for Payer: Cash Price |
$1,048.28
|
|
|
ABDOMINAL PARACERTESIS
|
Facility
|
OP
|
$25.52
|
|
| Hospital Charge Code |
40200290
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.93 |
| Max. Negotiated Rate |
$20.42 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$14.04
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.76
|
| Rate for Payer: Aetna Government |
$12.76
|
| Rate for Payer: Brighton Health Commercial |
$19.14
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.42
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.35
|
| Rate for Payer: Group Health Inc Commercial |
$12.76
|
| Rate for Payer: Group Health Inc Medicare |
$8.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.76
|
|
|
ABDOMINAL TUBAL LIGATION
|
Facility
|
IP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 58670
|
| Hospital Charge Code |
40052255
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$6,672.53
|
|
|
ABDOMINAL TUBAL LIGATION
|
Facility
|
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 58670
|
| Hospital Charge Code |
40052255
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$10,980.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4,670.77
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4,670.77
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4,670.77
|
| Rate for Payer: Brighton Health Commercial |
$10,980.08
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| 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 |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Humana Medicare |
$6,805.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
|
ABDOMINOPLASTY
|
Facility
|
IP
|
$15,862.45
|
|
|
Service Code
|
HCPCS 15830
|
| Hospital Charge Code |
40014292
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$7,541.13
|
|
|
ABDOMINOPLASTY
|
Facility
|
OP
|
$15,862.45
|
|
|
Service Code
|
HCPCS 15830
|
| Hospital Charge Code |
40014292
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$11,896.84 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$7,541.13
|
| Rate for Payer: Aetna Government |
$7,541.13
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5,278.79
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5,278.79
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5,278.79
|
| Rate for Payer: Brighton Health Commercial |
$11,896.84
|
| Rate for Payer: Cash Price |
$7,541.13
|
| Rate for Payer: Cash Price |
$7,541.13
|
| Rate for Payer: Cash Price |
$7,541.13
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$7,541.13
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$7,541.13
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$6,409.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$6,711.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$7,541.13
|
| Rate for Payer: Fidelis Qualified Health Plan |
$6,711.61
|
| Rate for Payer: Group Health Inc Commercial |
$7,541.13
|
| Rate for Payer: Group Health Inc Medicare |
$7,541.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,931.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$7,541.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6,409.96
|
| Rate for Payer: Healthfirst QHP |
$7,541.13
|
| Rate for Payer: Humana Medicare |
$7,691.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$7,541.13
|
| Rate for Payer: United Healthcare Commercial |
$2,683.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,541.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7,541.13
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6,032.90
|
| Rate for Payer: Wellcare Medicare |
$7,164.07
|
|
|
ABD PARACENTESIS
|
Facility
|
IP
|
$2,380.35
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
40021755
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,048.28
|
|
|
ABD PARACENTESIS
|
Facility
|
OP
|
$2,380.35
|
|
|
Service Code
|
HCPCS 49082
|
| Hospital Charge Code |
40021755
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$733.80 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,048.28
|
| Rate for Payer: Aetna Government |
$1,048.28
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$733.80
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$733.80
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$733.80
|
| Rate for Payer: Brighton Health Commercial |
$1,785.26
|
| Rate for Payer: Cash Price |
$1,048.28
|
| Rate for Payer: Cash Price |
$1,048.28
|
| Rate for Payer: Cash Price |
$1,048.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,048.28
|
| 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 |
$1,048.28
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$891.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$932.97
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,048.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$932.97
|
| Rate for Payer: Group Health Inc Commercial |
$1,048.28
|
| Rate for Payer: Group Health Inc Medicare |
$1,048.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,190.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,048.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$891.04
|
| Rate for Payer: Healthfirst QHP |
$1,048.28
|
| Rate for Payer: Humana Medicare |
$1,069.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,048.28
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,048.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,048.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$838.62
|
| Rate for Payer: Wellcare Medicare |
$995.87
|
|
|
ABD PERINEAL RESECTION
|
Facility
|
OP
|
$5,368.92
|
|
|
Service Code
|
HCPCS 45110
|
| Hospital Charge Code |
40011150
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,496.00 |
| Max. Negotiated Rate |
$4,026.69 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,952.91
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,170.32
|
| Rate for Payer: Aetna Government |
$2,170.32
|
| Rate for Payer: Brighton Health Commercial |
$4,026.69
|
| 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 |
$2,684.46
|
| Rate for Payer: Group Health Inc Medicare |
$1,879.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,684.46
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,684.46
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
AB, EBNA
|
Facility
|
OP
|
$38.23
|
|
|
Service Code
|
HCPCS 86664
|
| Hospital Charge Code |
30305618
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.70 |
| Max. Negotiated Rate |
$28.67 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$21.03
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.29
|
| Rate for Payer: Aetna Government |
$15.29
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$10.70
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$10.70
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$10.70
|
| Rate for Payer: Brighton Health Commercial |
$28.67
|
| Rate for Payer: Cash Price |
$15.29
|
| Rate for Payer: Cash Price |
$15.29
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15.29
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$24.31
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$20.57
|
| Rate for Payer: Elderplan Medicare Advantage |
$15.29
|
| Rate for Payer: EmblemHealth Commercial |
$15.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$13.00
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$15.29
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13.61
|
| Rate for Payer: Group Health Inc Commercial |
$15.29
|
| Rate for Payer: Group Health Inc Medicare |
$15.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.29
|
| Rate for Payer: Healthfirst QHP |
$15.29
|
| Rate for Payer: Humana Medicare |
$15.60
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15.29
|
| Rate for Payer: United Healthcare Commercial |
$19.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.29
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15.29
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.23
|
| Rate for Payer: Wellcare Medicare |
$13.76
|
|
|
AB, EBNA
|
Facility
|
IP
|
$38.23
|
|
|
Service Code
|
HCPCS 86664
|
| Hospital Charge Code |
30305618
|
|
Hospital Revenue Code
|
302
|
| Rate for Payer: Cash Price |
$15.29
|
|
|
ABEON MALE URO RETRACT SYS
|
Facility
|
OP
|
$550.00
|
|
|
Service Code
|
HCPCS C1813
|
| Hospital Charge Code |
40003447
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$192.50 |
| Max. Negotiated Rate |
$3,775.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$302.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,775.00
|
| Rate for Payer: Aetna Government |
$3,775.00
|
| Rate for Payer: Brighton Health Commercial |
$330.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$275.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$316.25
|
| Rate for Payer: EmblemHealth Commercial |
$275.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$577.50
|
| Rate for Payer: Group Health Inc Commercial |
$275.00
|
| Rate for Payer: Group Health Inc Medicare |
$192.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$275.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$275.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$357.50
|
|
|
ABEON MALE URO RETRACT SYS
|
Facility
|
IP
|
$550.00
|
|
|
Service Code
|
HCPCS C1813
|
| Hospital Charge Code |
40003447
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$275.00 |
| Max. Negotiated Rate |
$275.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$275.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$275.00
|
|
|
ABG'S 100% OXYGEN -ARTERIAL PUNCT
|
Facility
|
OP
|
$330.23
|
|
|
Service Code
|
HCPCS 36600 TC
|
| Hospital Charge Code |
40402702
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$103.40 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$147.72
|
| Rate for Payer: Aetna Government |
$147.72
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$103.40
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$103.40
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$103.40
|
| Rate for Payer: Brighton Health Commercial |
$247.67
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Cash Price |
$147.72
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$147.72
|
| 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 |
$147.72
|
| Rate for Payer: EmblemHealth Commercial |
$147.72
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$125.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$131.47
|
| Rate for Payer: Fidelis Medicare Advantage |
$147.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$131.47
|
| Rate for Payer: Group Health Inc Commercial |
$147.72
|
| Rate for Payer: Group Health Inc Medicare |
$147.72
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$165.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$147.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$125.56
|
| Rate for Payer: Healthfirst QHP |
$147.72
|
| Rate for Payer: Humana Medicare |
$150.67
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$147.72
|
| Rate for Payer: United Healthcare Commercial |
$165.12
|
| Rate for Payer: United Healthcare Medicare Advantage |
$147.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$147.72
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$118.18
|
| Rate for Payer: Wellcare Medicare |
$140.33
|
|
|
ABG'S 100% OXYGEN -ARTERIAL PUNCT
|
Facility
|
IP
|
$330.23
|
|
|
Service Code
|
HCPCS 36600 TC
|
| Hospital Charge Code |
40402702
|
|
Hospital Revenue Code
|
410
|
| Rate for Payer: Cash Price |
$147.72
|
|
