|
COROENT SM INTERLOCK 8X17X14 7
|
Facility
OP
|
$7,105.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
64905275
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$7,460.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,907.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
| Rate for Payer: Aetna Government |
$134.20
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,552.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4,085.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$7,460.25
|
| Rate for Payer: Group Health Inc Commercial |
$3,552.50
|
| Rate for Payer: Group Health Inc Medicare |
$2,486.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,552.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,552.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,618.25
|
|
|
COROENT XL 10X18X45MM 10D
|
Facility
OP
|
$12,305.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
64905335
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$12,920.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$6,767.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
| Rate for Payer: Aetna Government |
$134.20
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$6,152.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7,075.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$12,920.25
|
| Rate for Payer: Group Health Inc Commercial |
$6,152.50
|
| Rate for Payer: Group Health Inc Medicare |
$4,306.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6,152.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,152.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7,998.25
|
|
|
COROENT XL 10X18X45MM 10D
|
Facility
IP
|
$12,305.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
64905335
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,152.50 |
| Max. Negotiated Rate |
$6,152.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6,152.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,152.50
|
|
|
COROENT XL 8X18X45MM
|
Facility
IP
|
$11,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
64903533
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,750.00 |
| Max. Negotiated Rate |
$5,750.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5,750.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5,750.00
|
|
|
COROENT XL 8X18X45MM
|
Facility
OP
|
$11,500.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
64903533
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$12,075.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$6,325.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
| Rate for Payer: Aetna Government |
$134.20
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5,750.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6,612.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$12,075.00
|
| Rate for Payer: Group Health Inc Commercial |
$5,750.00
|
| Rate for Payer: Group Health Inc Medicare |
$4,025.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5,750.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5,750.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7,475.00
|
|
|
COROENT XLR 14X34X24 8D
|
Facility
IP
|
$16,930.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
64905178
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,465.00 |
| Max. Negotiated Rate |
$8,465.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8,465.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8,465.00
|
|
|
COROENT XLR 14X34X24 8D
|
Facility
OP
|
$16,930.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
64905178
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$17,776.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$9,311.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
| Rate for Payer: Aetna Government |
$134.20
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8,465.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9,734.75
|
| Rate for Payer: Fidelis Medicare Advantage |
$17,776.50
|
| Rate for Payer: Group Health Inc Commercial |
$8,465.00
|
| Rate for Payer: Group Health Inc Medicare |
$5,925.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8,465.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8,465.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11,004.50
|
|
|
COROENT XLR 16X38X28 8D
|
Facility
IP
|
$16,930.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
64905180
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,465.00 |
| Max. Negotiated Rate |
$8,465.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8,465.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8,465.00
|
|
|
COROENT XLR 16X38X28 8D
|
Facility
OP
|
$16,930.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
64905180
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$17,776.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$9,311.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
| Rate for Payer: Aetna Government |
$134.20
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8,465.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9,734.75
|
| Rate for Payer: Fidelis Medicare Advantage |
$17,776.50
|
| Rate for Payer: Group Health Inc Commercial |
$8,465.00
|
| Rate for Payer: Group Health Inc Medicare |
$5,925.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8,465.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8,465.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11,004.50
|
|
|
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC
|
Facility
IP
|
$134,691.29
|
|
|
Service Code
|
MS-DRG 233
|
| Min. Negotiated Rate |
$53,701.88 |
| Max. Negotiated Rate |
$134,691.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$115,005.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$115,487.91
|
| Rate for Payer: Aetna Government |
$115,487.91
|
| Rate for Payer: Brighton Health Commercial |
$113,094.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$117,797.67
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$134,691.29
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$111,153.04
|
| Rate for Payer: Elderplan Medicare Advantage |
$109,713.51
|
| Rate for Payer: EmblemHealth Commercial |
$66,881.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$115,487.91
|
| Rate for Payer: Group Health Inc Commercial |
$115,487.91
|
| Rate for Payer: Group Health Inc Medicare |
$115,487.91
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$115,487.91
|
| Rate for Payer: Healthfirst Medicare Advantage |
$53,701.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$115,487.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$115,487.91
|
| Rate for Payer: Wellcare Medicare |
$109,713.51
|
|
|
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC
|
Facility
IP
|
$89,762.54
|
|
|
Service Code
|
MS-DRG 234
|
| Min. Negotiated Rate |
$36,925.24 |
| Max. Negotiated Rate |
$89,762.54 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$76,643.04
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$79,409.12
|
| Rate for Payer: Aetna Government |
$79,409.12
|
| Rate for Payer: Brighton Health Commercial |
$75,369.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$80,997.30
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$89,762.54
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$74,075.90
|
| Rate for Payer: Elderplan Medicare Advantage |
$75,438.66
|
| Rate for Payer: EmblemHealth Commercial |
$44,572.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$79,409.12
|
| Rate for Payer: Group Health Inc Commercial |
$79,409.12
|
| Rate for Payer: Group Health Inc Medicare |
$79,409.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$79,409.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$36,925.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$79,409.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$79,409.12
|
| Rate for Payer: Wellcare Medicare |
$75,438.66
|
|
|
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
IP
|
$101,552.08
|
|
|
Service Code
|
MS-DRG 235
|
| Min. Negotiated Rate |
$41,327.53 |
| Max. Negotiated Rate |
$101,552.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$86,709.45
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$88,876.40
|
| Rate for Payer: Aetna Government |
$88,876.40
|
| Rate for Payer: Brighton Health Commercial |
$85,268.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$90,653.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$101,552.08
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$83,805.14
|
| Rate for Payer: Elderplan Medicare Advantage |
$84,432.58
|
| Rate for Payer: EmblemHealth Commercial |
$50,426.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$88,876.40
|
| Rate for Payer: Group Health Inc Commercial |
$88,876.40
|
| Rate for Payer: Group Health Inc Medicare |
$88,876.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$88,876.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$41,327.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$88,876.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$88,876.40
|
| Rate for Payer: Wellcare Medicare |
$84,432.58
|
|
|
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
IP
|
$69,787.48
|
|
|
Service Code
|
MS-DRG 236
|
| Min. Negotiated Rate |
$29,466.45 |
| Max. Negotiated Rate |
$69,787.48 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$59,587.49
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$63,368.70
|
| Rate for Payer: Aetna Government |
$63,368.70
|
| Rate for Payer: Brighton Health Commercial |
$58,597.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$64,636.07
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$69,787.48
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$57,591.63
|
| Rate for Payer: Elderplan Medicare Advantage |
$60,200.26
|
| Rate for Payer: EmblemHealth Commercial |
$34,653.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$63,368.70
|
| Rate for Payer: Group Health Inc Commercial |
$63,368.70
|
| Rate for Payer: Group Health Inc Medicare |
$63,368.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$63,368.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$29,466.45
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$63,368.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$63,368.70
|
| Rate for Payer: Wellcare Medicare |
$60,200.26
|
|
|
CORONARY BYPASS WITH PTCA WITH MCC
|
Facility
IP
|
$140,141.39
|
|
|
Service Code
|
MS-DRG 231
|
| Min. Negotiated Rate |
$55,736.96 |
| Max. Negotiated Rate |
$140,141.39 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$119,658.62
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$119,864.44
|
| Rate for Payer: Aetna Government |
$119,864.44
|
| Rate for Payer: Brighton Health Commercial |
$117,670.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$122,261.73
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$140,141.39
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$115,650.69
|
| Rate for Payer: Elderplan Medicare Advantage |
$113,871.22
|
| Rate for Payer: EmblemHealth Commercial |
$69,587.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$119,864.44
|
| Rate for Payer: Group Health Inc Commercial |
$119,864.44
|
| Rate for Payer: Group Health Inc Medicare |
$119,864.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$119,864.44
|
| Rate for Payer: Healthfirst Medicare Advantage |
$55,736.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$119,864.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$119,864.44
|
| Rate for Payer: Wellcare Medicare |
$113,871.22
|
|
|
CORONARY BYPASS WITH PTCA WITHOUT MCC
|
Facility
IP
|
$102,726.37
|
|
|
Service Code
|
MS-DRG 232
|
| Min. Negotiated Rate |
$41,766.00 |
| Max. Negotiated Rate |
$102,726.37 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$87,712.11
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$89,819.36
|
| Rate for Payer: Aetna Government |
$89,819.36
|
| Rate for Payer: Brighton Health Commercial |
$86,254.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$91,615.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$102,726.37
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$84,774.21
|
| Rate for Payer: Elderplan Medicare Advantage |
$85,328.39
|
| Rate for Payer: EmblemHealth Commercial |
$51,009.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$89,819.36
|
| Rate for Payer: Group Health Inc Commercial |
$89,819.36
|
| Rate for Payer: Group Health Inc Medicare |
$89,819.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$89,819.36
|
| Rate for Payer: Healthfirst Medicare Advantage |
$41,766.00
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$89,819.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$89,819.36
|
| Rate for Payer: Wellcare Medicare |
$85,328.39
|
|
|
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC
|
Facility
IP
|
$71,493.66
|
|
|
Service Code
|
MS-DRG 323
|
| Min. Negotiated Rate |
$30,103.55 |
| Max. Negotiated Rate |
$71,493.66 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$61,044.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$64,738.82
|
| Rate for Payer: Aetna Government |
$64,738.82
|
| Rate for Payer: Brighton Health Commercial |
$60,030.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$66,033.60
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$71,493.66
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$58,999.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$61,501.88
|
| Rate for Payer: EmblemHealth Commercial |
$35,500.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$64,738.82
|
| Rate for Payer: Group Health Inc Commercial |
$64,738.82
|
| Rate for Payer: Group Health Inc Medicare |
$64,738.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$64,738.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$30,103.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$64,738.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$64,738.82
|
| Rate for Payer: Wellcare Medicare |
$61,501.88
|
|
|
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
IP
|
$51,264.75
|
|
|
Service Code
|
MS-DRG 324
|
| Min. Negotiated Rate |
$22,549.98 |
| Max. Negotiated Rate |
$51,264.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$43,772.01
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$48,494.57
|
| Rate for Payer: Aetna Government |
$48,494.57
|
| Rate for Payer: Brighton Health Commercial |
$43,044.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$49,464.46
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51,264.75
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$42,305.87
|
| Rate for Payer: Elderplan Medicare Advantage |
$46,069.84
|
| Rate for Payer: EmblemHealth Commercial |
$25,455.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$48,494.57
|
| Rate for Payer: Group Health Inc Commercial |
$48,494.57
|
| Rate for Payer: Group Health Inc Medicare |
$48,494.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$48,494.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22,549.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$48,494.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$48,494.57
|
| Rate for Payer: Wellcare Medicare |
$46,069.84
|
|
|
CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE
|
Facility
IP
|
$45,664.42
|
|
|
Service Code
|
MS-DRG 325
|
| Min. Negotiated Rate |
$20,458.78 |
| Max. Negotiated Rate |
$45,664.42 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$38,990.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$43,997.38
|
| Rate for Payer: Aetna Government |
$43,997.38
|
| Rate for Payer: Brighton Health Commercial |
$38,342.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$44,877.33
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$45,664.42
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$37,684.24
|
| Rate for Payer: Elderplan Medicare Advantage |
$41,797.51
|
| Rate for Payer: EmblemHealth Commercial |
$22,674.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$43,997.38
|
| Rate for Payer: Group Health Inc Commercial |
$43,997.38
|
| Rate for Payer: Group Health Inc Medicare |
$43,997.38
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$43,997.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$20,458.78
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$43,997.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$43,997.38
|
| Rate for Payer: Wellcare Medicare |
$41,797.51
|
|
|
CORONAVIRUS/COVID-19 TEST
|
Facility
OP
|
$52.00
|
|
|
Service Code
|
HCPCS U0002
|
| Hospital Charge Code |
40601999
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$51.31 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$28.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$51.31
|
| Rate for Payer: Aetna Government |
$51.31
|
| Rate for Payer: Cash Price |
$51.31
|
| Rate for Payer: Cash Price |
$51.31
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$51.31
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$41.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$35.36
|
| Rate for Payer: Elderplan Medicare Advantage |
$51.31
|
| Rate for Payer: EmblemHealth Commercial |
$51.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$46.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$43.61
|
| Rate for Payer: Fidelis Essential Plan QHP |
$45.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$51.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$45.67
|
| Rate for Payer: Group Health Inc Commercial |
$51.31
|
| Rate for Payer: Group Health Inc Medicare |
$51.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$51.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$51.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$43.61
|
| Rate for Payer: Healthfirst QHP |
$51.31
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$51.31
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$51.31
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$41.05
|
| Rate for Payer: Wellcare Medicare |
$46.18
|
|
|
CORONECTOMY-PART TOOTH REMOVAL
|
Facility
OP
|
$450.00
|
|
|
Service Code
|
HCPCS D7251
|
| Hospital Charge Code |
42300746
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$247.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,763.60
|
| Rate for Payer: Aetna Government |
$1,763.60
|
| Rate for Payer: Cash Price |
$1,763.60
|
| Rate for Payer: Cash Price |
$1,763.60
|
| Rate for Payer: Cash Price |
$1,763.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,763.60
|
| 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 |
$1,763.60
|
| Rate for Payer: EmblemHealth Commercial |
$1,763.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,499.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,569.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,763.60
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,569.60
|
| Rate for Payer: Group Health Inc Commercial |
$1,763.60
|
| Rate for Payer: Group Health Inc Medicare |
$1,763.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$225.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,763.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,499.06
|
| Rate for Payer: Healthfirst QHP |
$1,763.60
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,763.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,763.60
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,410.88
|
| Rate for Payer: Wellcare Medicare |
$1,675.42
|
|
|
CORONOIDECTOMY
|
Facility
OP
|
$1,377.50
|
|
|
Service Code
|
HCPCS D7991
|
| Hospital Charge Code |
42302160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$482.12 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$757.62
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,101.83
|
| Rate for Payer: Aetna Government |
$1,101.83
|
| 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: Group Health Inc Commercial |
$688.75
|
| Rate for Payer: Group Health Inc Medicare |
$482.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$688.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$688.75
|
|
|
CORRECT BUNION BY DOUBLE OSTEOTOM
|
Facility
OP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 28299
|
| Hospital Charge Code |
40019903
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$641.54 |
| Max. Negotiated Rate |
$9,058.92 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8,273.12
|
| Rate for Payer: Aetna Government |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8,273.12
|
| 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 |
$8,273.12
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$641.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7,032.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7,363.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$8,273.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7,363.08
|
| Rate for Payer: Group Health Inc Commercial |
$8,273.12
|
| Rate for Payer: Group Health Inc Medicare |
$8,273.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9,058.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8,273.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$712.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,032.15
|
| Rate for Payer: Healthfirst QHP |
$8,273.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8,273.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8,273.12
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6,618.50
|
| Rate for Payer: Wellcare Medicare |
$7,859.46
|
|
|
CORRECT BUNION BY PHALANX OSTEOTO
|
Facility
OP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 28298
|
| Hospital Charge Code |
40019902
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$549.86 |
| Max. Negotiated Rate |
$9,058.92 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8,273.12
|
| Rate for Payer: Aetna Government |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8,273.12
|
| 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 |
$8,273.12
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$549.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7,032.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7,363.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$8,273.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7,363.08
|
| Rate for Payer: Group Health Inc Commercial |
$8,273.12
|
| Rate for Payer: Group Health Inc Medicare |
$8,273.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9,058.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8,273.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$610.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,032.15
|
| Rate for Payer: Healthfirst QHP |
$8,273.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8,273.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8,273.12
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6,618.50
|
| Rate for Payer: Wellcare Medicare |
$7,859.46
|
|
|
CORRECT BUNION W RESECT OF JOINT
|
Facility
OP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 28291
|
| Hospital Charge Code |
40019901
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$520.70 |
| Max. Negotiated Rate |
$9,058.92 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8,273.12
|
| Rate for Payer: Aetna Government |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8,273.12
|
| 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 |
$8,273.12
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$520.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7,032.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7,363.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$8,273.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7,363.08
|
| Rate for Payer: Group Health Inc Commercial |
$8,273.12
|
| Rate for Payer: Group Health Inc Medicare |
$8,273.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9,058.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8,273.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$578.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,032.15
|
| Rate for Payer: Healthfirst QHP |
$8,273.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8,273.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8,273.12
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6,618.50
|
| Rate for Payer: Wellcare Medicare |
$7,859.46
|
|
|
CORRECTION HALLUX VALGUS
|
Facility
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 28292
|
| Hospital Charge Code |
40021495
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$520.56 |
| Max. Negotiated Rate |
$4,145.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,743.15
|
| Rate for Payer: Aetna Government |
$3,743.15
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,743.15
|
| 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 |
$3,743.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$520.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,181.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,331.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,743.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,331.40
|
| Rate for Payer: Group Health Inc Commercial |
$3,743.15
|
| Rate for Payer: Group Health Inc Medicare |
$3,743.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,145.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,743.15
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$578.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,743.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,743.15
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,994.52
|
| Rate for Payer: Wellcare Medicare |
$3,555.99
|
|
