|
HC EP MAP,TACHYCARDIA SITE W/CATH MANIPUL
|
Facility
|
IP
|
$1,153.00
|
|
|
Service Code
|
CPT 93609
|
| Hospital Charge Code |
4809360901
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$576.50 |
| Max. Negotiated Rate |
$576.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$576.50
|
|
|
HC EP PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 93287
|
| Hospital Charge Code |
4809328703
|
|
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 PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 93287
|
| Hospital Charge Code |
4809328703
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$31.48 |
| Max. Negotiated Rate |
$316.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$59.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$31.48
|
| Rate for Payer: Aetna Government |
$31.48
|
| Rate for Payer: Brighton Health Commercial |
$81.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$87.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$74.12
|
| Rate for Payer: EmblemHealth Commercial |
$54.50
|
| Rate for Payer: Group Health Inc Commercial |
$54.50
|
| Rate for Payer: Group Health Inc Medicare |
$38.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$54.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$54.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$58.27
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
|
|
HC EP PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM
|
Facility
|
OP
|
$146.00
|
|
|
Service Code
|
CPT 93260
|
| Hospital Charge Code |
4809326005
|
|
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 |
$84.93
|
| 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 PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM
|
Facility
|
IP
|
$146.00
|
|
|
Service Code
|
CPT 93260
|
| Hospital Charge Code |
4809326005
|
|
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 PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 93284
|
| Hospital Charge Code |
4809328403
|
|
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 PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 93284
|
| Hospital Charge Code |
4809328401
|
|
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 PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 93284
|
| Hospital Charge Code |
4809328401
|
|
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 |
$116.80
|
| 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 PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 93284
|
| Hospital Charge Code |
4809328403
|
|
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 |
$116.80
|
| 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 PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 93283
|
| Hospital Charge Code |
4809328306
|
|
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 |
$108.31
|
| 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 PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 93283
|
| Hospital Charge Code |
4809328306
|
|
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 PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 93282
|
| Hospital Charge Code |
4809328206
|
|
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 |
$88.43
|
| 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 PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 93282
|
| Hospital Charge Code |
4809328206
|
|
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 PROGRAM EVAL IMPLANTABLE DEV IN PRSN ILR SYSTEM
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 93285
|
| Hospital Charge Code |
4809328505
|
|
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 |
$66.74
|
| 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 PROGRAM EVAL IMPLANTABLE DEV IN PRSN ILR SYSTEM
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 93285
|
| Hospital Charge Code |
4809328505
|
|
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 PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 93280
|
| Hospital Charge Code |
4809328006
|
|
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 PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 93280
|
| Hospital Charge Code |
4809328006
|
|
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 |
$87.38
|
| 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 PROGRAM EVAL IMPLANTABLE IN PRSN 1 LD PACEMAKER
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 93279
|
| Hospital Charge Code |
4809327906
|
|
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 PROGRAM EVAL IMPLANTABLE IN PRSN 1 LD PACEMAKER
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 93279
|
| Hospital Charge Code |
4809327906
|
|
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 |
$75.09
|
| 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 PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER
|
Facility
|
OP
|
$109.00
|
|
|
Service Code
|
CPT 93281
|
| Hospital Charge Code |
4809328105
|
|
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 |
$93.08
|
| 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 PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER
|
Facility
|
IP
|
$109.00
|
|
|
Service Code
|
CPT 93281
|
| Hospital Charge Code |
4809328105
|
|
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 REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB
|
Facility
|
IP
|
$14,070.00
|
|
|
Service Code
|
CPT 33273
|
| Hospital Charge Code |
4803327301
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$7,035.00 |
| Max. Negotiated Rate |
$7,035.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,035.00
|
|
|
HC EP REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB
|
Facility
|
OP
|
$14,070.00
|
|
|
Service Code
|
CPT 33273
|
| Hospital Charge Code |
4803327301
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$316.00 |
| Max. Negotiated Rate |
$11,256.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,446.57
|
| Rate for Payer: Aetna Government |
$4,446.57
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,112.60
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,112.60
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,112.60
|
| Rate for Payer: Brighton Health Commercial |
$10,552.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,446.57
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$11,256.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9,567.60
|
| Rate for Payer: Elderplan Medicare Advantage |
$4,446.57
|
| Rate for Payer: EmblemHealth Commercial |
$4,446.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4,001.91
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,779.58
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,957.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,446.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,957.45
|
| Rate for Payer: Group Health Inc Commercial |
$4,446.57
|
| Rate for Payer: Group Health Inc Medicare |
$4,446.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,446.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,953.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$467.33
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,779.58
|
| Rate for Payer: Healthfirst QHP |
$4,446.57
|
| Rate for Payer: Humana Medicare |
$4,535.50
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,446.57
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,446.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,446.57
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4,224.24
|
| Rate for Payer: Wellcare Medicare |
$4,224.24
|
|
|
HC EP RIGHT VENTRICULAR RECORDING
|
Facility
|
IP
|
$28,270.00
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
4809360301
|
|
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 RIGHT VENTRICULAR RECORDING
|
Facility
|
OP
|
$28,270.00
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
4809360301
|
|
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 |
$1,483.28
|
| Rate for Payer: Aetna Government |
$1,483.28
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,038.30
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,038.30
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,038.30
|
| Rate for Payer: Brighton Health Commercial |
$21,202.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,483.28
|
| 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 |
$1,483.28
|
| Rate for Payer: EmblemHealth Commercial |
$1,483.28
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,334.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,260.79
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,320.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,483.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,320.12
|
| Rate for Payer: Group Health Inc Commercial |
$1,483.28
|
| Rate for Payer: Group Health Inc Medicare |
$1,483.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,483.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,483.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,260.79
|
| Rate for Payer: Healthfirst QHP |
$1,483.28
|
| Rate for Payer: Humana Medicare |
$1,512.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,483.28
|
| Rate for Payer: United Healthcare Commercial |
$316.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,483.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,483.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,409.12
|
| Rate for Payer: Wellcare Medicare |
$1,409.12
|
|
