|
HC EP INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS
|
Facility
|
IP
|
$134,686.00
|
|
|
Service Code
|
CPT 33221
|
| Hospital Charge Code |
4803322101
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$67,343.00 |
| Max. Negotiated Rate |
$67,343.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$67,343.00
|
|
|
HC EP INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS
|
Facility
|
OP
|
$134,686.00
|
|
|
Service Code
|
CPT 33221
|
| Hospital Charge Code |
4803322101
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$316.00 |
| Max. Negotiated Rate |
$107,748.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$16,751.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$23,301.52
|
| Rate for Payer: Aetna Government |
$23,301.52
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$16,311.06
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$16,311.06
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$16,311.06
|
| Rate for Payer: Brighton Health Commercial |
$101,014.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$23,301.52
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$107,748.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$91,586.48
|
| Rate for Payer: Elderplan Medicare Advantage |
$23,301.52
|
| Rate for Payer: EmblemHealth Commercial |
$23,301.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20,971.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$19,806.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$20,738.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$23,301.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$20,738.35
|
| Rate for Payer: Group Health Inc Commercial |
$23,301.52
|
| Rate for Payer: Group Health Inc Medicare |
$23,301.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23,301.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$13,486.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$415.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$19,806.29
|
| Rate for Payer: Healthfirst QHP |
$23,301.52
|
| Rate for Payer: Humana Medicare |
$23,767.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$23,301.52
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$23,301.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$23,301.52
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$22,136.44
|
| Rate for Payer: Wellcare Medicare |
$22,136.44
|
|
|
HC EP INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB
|
Facility
|
OP
|
$146.00
|
|
|
Service Code
|
CPT 93261
|
| Hospital Charge Code |
4809326104
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$31.89 |
| Max. Negotiated Rate |
$316.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$80.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$45.56
|
| Rate for Payer: Aetna Government |
$45.56
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$31.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$31.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$31.89
|
| Rate for Payer: Brighton Health Commercial |
$109.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$45.56
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$116.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$99.28
|
| Rate for Payer: Elderplan Medicare Advantage |
$45.56
|
| Rate for Payer: EmblemHealth Commercial |
$45.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$41.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$38.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$40.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$45.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$40.55
|
| Rate for Payer: Group Health Inc Commercial |
$45.56
|
| Rate for Payer: Group Health Inc Medicare |
$45.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$45.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$78.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$38.73
|
| Rate for Payer: Healthfirst QHP |
$45.56
|
| Rate for Payer: Humana Medicare |
$46.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$45.56
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$45.56
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$45.56
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$43.28
|
| Rate for Payer: Wellcare Medicare |
$43.28
|
|
|
HC EP INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB
|
Facility
|
IP
|
$146.00
|
|
|
Service Code
|
CPT 93261
|
| Hospital Charge Code |
4809326104
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$73.00 |
| Max. Negotiated Rate |
$73.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$73.00
|
|
|
HC EP INTERROGATION EVAL IN PERSON 1/DUAL/MLT LEAD PM
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 93288
|
| Hospital Charge Code |
4809328805
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$31.89 |
| Max. Negotiated Rate |
$342.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$45.56
|
| Rate for Payer: Aetna Government |
$45.56
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$31.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$31.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$31.89
|
| Rate for Payer: Brighton Health Commercial |
$81.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$45.56
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$87.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$74.12
|
| Rate for Payer: Elderplan Medicare Advantage |
$45.56
|
| Rate for Payer: EmblemHealth Commercial |
$45.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$41.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$38.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$40.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$45.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$40.55
|
| Rate for Payer: Group Health Inc Commercial |
$45.56
|
| Rate for Payer: Group Health Inc Medicare |
$45.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$45.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$63.02
|
| Rate for Payer: Healthfirst Medicare Advantage |
$38.73
|
| Rate for Payer: Healthfirst QHP |
$45.56
|
| Rate for Payer: Humana Medicare |
$46.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$45.56
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$45.56
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$45.56
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$43.28
|
| Rate for Payer: Wellcare Medicare |
$43.28
|
|
|
HC EP INTERROGATION EVAL IN PERSON 1/DUAL/MLT LEAD PM
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 93288
|
| Hospital Charge Code |
4809328805
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$54.50 |
| Max. Negotiated Rate |
$54.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$54.50
|
|
|
HC EP INTERROGATION EVALUATION IN PERSON ILR SYSTEM
|
Facility
|
IP
|
$69.00
|
|
|
Service Code
|
CPT 93291
|
| Hospital Charge Code |
4809329107
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$34.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34.50
|
|
|
HC EP INTERROGATION EVALUATION IN PERSON ILR SYSTEM
|
Facility
|
OP
|
$69.00
|
|
|
Service Code
|
CPT 93291
|
| Hospital Charge Code |
4809329107
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$20.94 |
| Max. Negotiated Rate |
$316.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$37.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$29.92
|
| Rate for Payer: Aetna Government |
$29.92
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$20.94
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$20.94
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$20.94
|
| Rate for Payer: Brighton Health Commercial |
$51.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$29.92
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$55.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$46.92
|
| Rate for Payer: Elderplan Medicare Advantage |
$29.92
|
| Rate for Payer: EmblemHealth Commercial |
$29.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$26.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$25.43
|
| Rate for Payer: Fidelis Essential Plan QHP |
$26.63
|
| Rate for Payer: Fidelis Medicare Advantage |
$29.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$26.63
|
| Rate for Payer: Group Health Inc Commercial |
$29.92
|
| Rate for Payer: Group Health Inc Medicare |
$29.92
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$29.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$29.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$54.74
|
| Rate for Payer: Healthfirst Medicare Advantage |
$25.43
|
| Rate for Payer: Healthfirst QHP |
$29.92
|
| Rate for Payer: Humana Medicare |
$30.52
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$29.92
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$29.92
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$28.42
|
| Rate for Payer: Wellcare Medicare |
$28.42
|
|
|
HC EP INTERROGATION REMOTE </90 D TECHNICIAN REVIEW
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 93296
|
| Hospital Charge Code |
4809329603
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$23.52 |
| Max. Negotiated Rate |
$342.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$45.56
|
| Rate for Payer: Aetna Government |
$45.56
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$31.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$31.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$31.89
|
| Rate for Payer: Brighton Health Commercial |
$81.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$45.56
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$87.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$74.12
|
| Rate for Payer: Elderplan Medicare Advantage |
$45.56
|
| Rate for Payer: EmblemHealth Commercial |
$45.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$41.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$38.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$40.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$45.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$40.55
|
| Rate for Payer: Group Health Inc Commercial |
$45.56
|
| Rate for Payer: Group Health Inc Medicare |
$45.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$45.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$38.73
|
| Rate for Payer: Healthfirst QHP |
$45.56
|
| Rate for Payer: Humana Medicare |
$46.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$45.56
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$45.56
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$45.56
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$43.28
|
| Rate for Payer: Wellcare Medicare |
$43.28
|
|
|
HC EP INTERROGATION REMOTE </90 D TECHNICIAN REVIEW
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 93296
|
| Hospital Charge Code |
4809329603
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$54.50 |
| Max. Negotiated Rate |
$54.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$54.50
|
|
|
HC EP INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS
|
Facility
|
IP
|
$419.00
|
|
|
Service Code
|
CPT 93750
|
| Hospital Charge Code |
4809375001
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$209.50 |
| Max. Negotiated Rate |
$209.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$209.50
|
|
|
HC EP INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS
|
Facility
|
OP
|
$419.00
|
|
|
Service Code
|
CPT 93750
|
| Hospital Charge Code |
4809375001
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$46.29 |
| Max. Negotiated Rate |
$335.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$230.45
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$112.15
|
| Rate for Payer: Aetna Government |
$112.15
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$78.50
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$78.50
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$78.50
|
| Rate for Payer: Brighton Health Commercial |
$314.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$112.15
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$335.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$284.92
|
| Rate for Payer: Elderplan Medicare Advantage |
$112.15
|
| Rate for Payer: EmblemHealth Commercial |
$112.15
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$100.94
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$95.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$99.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$112.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$99.81
|
| Rate for Payer: Group Health Inc Commercial |
$112.15
|
| Rate for Payer: Group Health Inc Medicare |
$112.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$112.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$112.15
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$46.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$95.33
|
| Rate for Payer: Healthfirst QHP |
$112.15
|
| Rate for Payer: Humana Medicare |
$114.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$112.15
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$112.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$112.15
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$106.54
|
| Rate for Payer: Wellcare Medicare |
$106.54
|
|
|
HC EP INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 93289
|
| Hospital Charge Code |
4809328905
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$31.89 |
| Max. Negotiated Rate |
$316.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$59.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$45.56
|
| Rate for Payer: Aetna Government |
$45.56
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$31.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$31.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$31.89
|
| Rate for Payer: Brighton Health Commercial |
$81.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$45.56
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$87.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$74.12
|
| Rate for Payer: Elderplan Medicare Advantage |
$45.56
|
| Rate for Payer: EmblemHealth Commercial |
$45.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$41.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$38.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$40.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$45.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$40.55
|
| Rate for Payer: Group Health Inc Commercial |
$45.56
|
| Rate for Payer: Group Health Inc Medicare |
$45.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$45.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$79.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$38.73
|
| Rate for Payer: Healthfirst QHP |
$45.56
|
| Rate for Payer: Humana Medicare |
$46.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$45.56
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$45.56
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$45.56
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$43.28
|
| Rate for Payer: Wellcare Medicare |
$43.28
|
|
|
HC EP INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 93289
|
| Hospital Charge Code |
4809328905
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$54.50 |
| Max. Negotiated Rate |
$54.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$54.50
|
|
|
HC EP INTRA-ATRIAL PACING
|
Facility
|
IP
|
$28,270.00
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
4809361001
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$14,135.00 |
| Max. Negotiated Rate |
$14,135.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14,135.00
|
|
|
HC EP INTRA-ATRIAL PACING
|
Facility
|
OP
|
$28,270.00
|
|
|
Service Code
|
CPT 93610
|
| Hospital Charge Code |
4809361001
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$316.00 |
| Max. Negotiated Rate |
$22,616.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15,548.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9,271.29
|
| Rate for Payer: Aetna Government |
$9,271.29
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6,489.90
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6,489.90
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6,489.90
|
| Rate for Payer: Brighton Health Commercial |
$21,202.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9,271.29
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22,616.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$19,223.60
|
| Rate for Payer: Elderplan Medicare Advantage |
$9,271.29
|
| Rate for Payer: EmblemHealth Commercial |
$9,271.29
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8,344.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7,880.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8,251.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$9,271.29
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8,251.45
|
| Rate for Payer: Group Health Inc Commercial |
$9,271.29
|
| Rate for Payer: Group Health Inc Medicare |
$9,271.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9,271.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9,271.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,880.60
|
| Rate for Payer: Healthfirst QHP |
$9,271.29
|
| Rate for Payer: Humana Medicare |
$9,456.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9,271.29
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,271.29
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9,271.29
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8,807.73
|
| Rate for Payer: Wellcare Medicare |
$8,807.73
|
|
|
HC EP INTRA-ATRIAL RECORDING
|
Facility
|
OP
|
$28,270.00
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
4809360201
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$316.00 |
| Max. Negotiated Rate |
$22,616.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15,548.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9,271.29
|
| Rate for Payer: Aetna Government |
$9,271.29
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6,489.90
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6,489.90
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6,489.90
|
| Rate for Payer: Brighton Health Commercial |
$21,202.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9,271.29
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22,616.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$19,223.60
|
| Rate for Payer: Elderplan Medicare Advantage |
$9,271.29
|
| Rate for Payer: EmblemHealth Commercial |
$9,271.29
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8,344.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7,880.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8,251.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$9,271.29
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8,251.45
|
| Rate for Payer: Group Health Inc Commercial |
$9,271.29
|
| Rate for Payer: Group Health Inc Medicare |
$9,271.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9,271.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9,271.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,880.60
|
| Rate for Payer: Healthfirst QHP |
$9,271.29
|
| Rate for Payer: Humana Medicare |
$9,456.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9,271.29
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,271.29
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9,271.29
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8,807.73
|
| Rate for Payer: Wellcare Medicare |
$8,807.73
|
|
|
HC EP INTRA-ATRIAL RECORDING
|
Facility
|
IP
|
$28,270.00
|
|
|
Service Code
|
CPT 93602
|
| Hospital Charge Code |
4809360201
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$14,135.00 |
| Max. Negotiated Rate |
$14,135.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14,135.00
|
|
|
HC EP INTRACARD ELECTROPHYS 3-DIMENS MAPPING
|
Facility
|
OP
|
$1,095.00
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
4809361301
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$316.00 |
| Max. Negotiated Rate |
$876.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$602.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$370.66
|
| Rate for Payer: Aetna Government |
$370.66
|
| Rate for Payer: Brighton Health Commercial |
$821.25
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$876.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$744.60
|
| Rate for Payer: EmblemHealth Commercial |
$547.50
|
| Rate for Payer: Group Health Inc Commercial |
$547.50
|
| Rate for Payer: Group Health Inc Medicare |
$383.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$547.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$547.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$334.39
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
|
|
HC EP INTRACARD ELECTROPHYS 3-DIMENS MAPPING
|
Facility
|
IP
|
$1,095.00
|
|
|
Service Code
|
CPT 93613
|
| Hospital Charge Code |
4809361301
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$547.50 |
| Max. Negotiated Rate |
$547.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$547.50
|
|
|
HC EP INTRAVENTRICULAR PACING
|
Facility
|
IP
|
$28,270.00
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
4809361201
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$14,135.00 |
| Max. Negotiated Rate |
$14,135.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14,135.00
|
|
|
HC EP INTRAVENTRICULAR PACING
|
Facility
|
OP
|
$28,270.00
|
|
|
Service Code
|
CPT 93612
|
| Hospital Charge Code |
4809361201
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$316.00 |
| Max. Negotiated Rate |
$22,616.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15,548.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9,271.29
|
| Rate for Payer: Aetna Government |
$9,271.29
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6,489.90
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6,489.90
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6,489.90
|
| Rate for Payer: Brighton Health Commercial |
$21,202.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9,271.29
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22,616.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$19,223.60
|
| Rate for Payer: Elderplan Medicare Advantage |
$9,271.29
|
| Rate for Payer: EmblemHealth Commercial |
$9,271.29
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8,344.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7,880.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8,251.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$9,271.29
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8,251.45
|
| Rate for Payer: Group Health Inc Commercial |
$9,271.29
|
| Rate for Payer: Group Health Inc Medicare |
$9,271.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9,271.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9,271.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,880.60
|
| Rate for Payer: Healthfirst QHP |
$9,271.29
|
| Rate for Payer: Humana Medicare |
$9,456.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9,271.29
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9,271.29
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9,271.29
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$8,807.73
|
| Rate for Payer: Wellcare Medicare |
$8,807.73
|
|
|
HC EPISIOTOMY OF VAGINAL REPAIR
|
Facility
|
OP
|
$7,566.00
|
|
|
Service Code
|
CPT 59300
|
| Hospital Charge Code |
4505930001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$119.68 |
| Max. Negotiated Rate |
$4,079.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,884.81
|
| Rate for Payer: Aetna Government |
$3,884.81
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,719.37
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,719.37
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,719.37
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$3,884.81
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$3,884.81
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,884.81
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$792.81
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$673.89
|
| Rate for Payer: Elderplan Medicare Advantage |
$3,884.81
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,496.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,302.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,457.48
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,884.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,457.48
|
| 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 |
$3,884.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$119.68
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$3,884.81
|
| Rate for Payer: Humana Medicare |
$3,962.51
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$4,079.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,884.81
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,884.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,884.81
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,690.57
|
| Rate for Payer: Wellcare Medicare |
$3,690.57
|
|
|
HC EPISIOTOMY OF VAGINAL REPAIR
|
Facility
|
IP
|
$7,566.00
|
|
|
Service Code
|
CPT 59300
|
| Hospital Charge Code |
4505930001
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$3,783.00 |
| Max. Negotiated Rate |
$3,783.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,783.00
|
|
|
HC EP MAP,TACHYCARDIA SITE W/CATH MANIPUL
|
Facility
|
OP
|
$1,153.00
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
4809360901
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$316.00 |
| Max. Negotiated Rate |
$922.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$634.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$356.97
|
| Rate for Payer: Aetna Government |
$356.97
|
| Rate for Payer: Brighton Health Commercial |
$864.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$922.40
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$784.04
|
| Rate for Payer: EmblemHealth Commercial |
$576.50
|
| Rate for Payer: Group Health Inc Commercial |
$576.50
|
| Rate for Payer: Group Health Inc Medicare |
$403.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$576.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$576.50
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
|
