|
HC EVOKED AUDITORY TEST,COMPREHSV
|
Facility
|
OP
|
$766.00
|
|
|
Service Code
|
CPT 92588
|
| Hospital Charge Code |
4719258801
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$36.87 |
| Max. Negotiated Rate |
$612.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$421.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$380.47
|
| Rate for Payer: Aetna Government |
$380.47
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$266.33
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$266.33
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$266.33
|
| Rate for Payer: Brighton Health Commercial |
$574.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$380.47
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$612.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$520.88
|
| Rate for Payer: Elderplan Medicare Advantage |
$380.47
|
| Rate for Payer: EmblemHealth Commercial |
$380.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$342.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$323.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$338.62
|
| Rate for Payer: Fidelis Medicare Advantage |
$380.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$338.62
|
| Rate for Payer: Group Health Inc Commercial |
$380.47
|
| Rate for Payer: Group Health Inc Medicare |
$380.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$380.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$380.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$36.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$323.40
|
| Rate for Payer: Healthfirst QHP |
$380.47
|
| Rate for Payer: Humana Medicare |
$388.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$380.47
|
| Rate for Payer: United Healthcare Commercial |
$158.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$380.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$380.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$361.45
|
| Rate for Payer: Wellcare Medicare |
$361.45
|
|
|
HC EVOKED AUDITORY TEST,COMPREHSV
|
Facility
|
IP
|
$766.00
|
|
|
Service Code
|
CPT 92588
|
| Hospital Charge Code |
4719258801
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$383.00 |
| Max. Negotiated Rate |
$383.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$383.00
|
|
|
HC EVOKED AUDITORY TEST,LIMITED
|
Facility
|
OP
|
$766.00
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
4719258701
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$24.16 |
| Max. Negotiated Rate |
$612.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$421.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$380.47
|
| Rate for Payer: Aetna Government |
$380.47
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$266.33
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$266.33
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$266.33
|
| Rate for Payer: Brighton Health Commercial |
$574.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$380.47
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$612.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$520.88
|
| Rate for Payer: Elderplan Medicare Advantage |
$380.47
|
| Rate for Payer: EmblemHealth Commercial |
$380.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$342.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$323.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$338.62
|
| Rate for Payer: Fidelis Medicare Advantage |
$380.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$338.62
|
| Rate for Payer: Group Health Inc Commercial |
$380.47
|
| Rate for Payer: Group Health Inc Medicare |
$380.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$380.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$380.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24.16
|
| Rate for Payer: Healthfirst Medicare Advantage |
$323.40
|
| Rate for Payer: Healthfirst QHP |
$380.47
|
| Rate for Payer: Humana Medicare |
$388.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$380.47
|
| Rate for Payer: United Healthcare Commercial |
$158.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$380.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$380.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$361.45
|
| Rate for Payer: Wellcare Medicare |
$361.45
|
|
|
HC EVOKED AUDITORY TEST,LIMITED
|
Facility
|
IP
|
$766.00
|
|
|
Service Code
|
CPT 92587
|
| Hospital Charge Code |
4719258701
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$383.00 |
| Max. Negotiated Rate |
$383.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$383.00
|
|
|
HC EVOKED AUDITORY TEST QUAL
|
Facility
|
IP
|
$174.00
|
|
|
Service Code
|
CPT 92558
|
| Hospital Charge Code |
4719255801
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$87.00 |
| Max. Negotiated Rate |
$87.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$87.00
|
|
|
HC EVOKED AUDITORY TEST QUAL
|
Facility
|
OP
|
$174.00
|
|
|
Service Code
|
CPT 92558
|
| Hospital Charge Code |
4719255801
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$9.06 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$95.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.06
|
| Rate for Payer: Aetna Government |
$9.06
|
| Rate for Payer: Brighton Health Commercial |
$130.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$139.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$118.32
|
| Rate for Payer: EmblemHealth Commercial |
$87.00
|
| Rate for Payer: Group Health Inc Commercial |
$87.00
|
| Rate for Payer: Group Health Inc Medicare |
$60.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$87.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$87.00
|
| Rate for Payer: United Healthcare Commercial |
$158.00
|
|
|
HC EVUSHELD INJECTION ADMINISTRATION
|
Facility
|
IP
|
$102.00
|
|
|
Service Code
|
CPT M0220
|
| Hospital Charge Code |
771M022001
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$51.00 |
| Max. Negotiated Rate |
$51.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
|
|
HC EVUSHELD INJECTION ADMINISTRATION
|
Facility
|
OP
|
$102.00
|
|
|
Service Code
|
CPT M0220
|
| Hospital Charge Code |
771M022001
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$44.00 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$56.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$150.50
|
| Rate for Payer: Aetna Government |
$150.50
|
| Rate for Payer: Brighton Health Commercial |
$76.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$81.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$69.36
|
| Rate for Payer: EmblemHealth Commercial |
$250.00
|
| Rate for Payer: Group Health Inc Commercial |
$250.00
|
| Rate for Payer: Group Health Inc Medicare |
$250.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$51.00
|
| Rate for Payer: United Healthcare Commercial |
$44.00
|
|
|
HC EXAM,SYNOVIAL FLUID CRYSTALS - SYNOVIAL FLUID CRYSTAL
|
Facility
|
IP
|
$54.00
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
3008906001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.00 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$27.00
|
|
|
HC EXAM,SYNOVIAL FLUID CRYSTALS - SYNOVIAL FLUID CRYSTAL
|
Facility
|
OP
|
$54.00
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
3008906001
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.13 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$29.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$7.33
|
| Rate for Payer: Aetna Government |
$7.33
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5.13
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5.13
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5.13
|
| Rate for Payer: Brighton Health Commercial |
$40.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$7.33
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$12.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$10.23
|
| Rate for Payer: Elderplan Medicare Advantage |
$7.33
|
| Rate for Payer: EmblemHealth Commercial |
$7.33
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$6.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$6.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$6.52
|
| Rate for Payer: Fidelis Medicare Advantage |
$7.33
|
| Rate for Payer: Fidelis Qualified Health Plan |
$6.52
|
| Rate for Payer: Group Health Inc Commercial |
$7.33
|
| Rate for Payer: Group Health Inc Medicare |
$7.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$7.33
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$6.06
|
| Rate for Payer: Healthfirst Essential Plan |
$13.63
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7.33
|
| Rate for Payer: Healthfirst QHP |
$7.33
|
| Rate for Payer: Humana Medicare |
$7.48
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$7.33
|
| Rate for Payer: United Healthcare Commercial |
$9.05
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7.33
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6.06
|
| Rate for Payer: Wellcare Medicare |
$6.60
|
|
|
HC EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I
|
Facility
|
IP
|
$10,439.00
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
3614753601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,219.50 |
| Max. Negotiated Rate |
$5,219.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5,219.50
|
|
|
HC EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I
|
Facility
|
OP
|
$10,439.00
|
|
|
Service Code
|
CPT 47536
|
| Hospital Charge Code |
3614753601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$145.65 |
| Max. Negotiated Rate |
$7,829.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,311.88
|
| Rate for Payer: Aetna Government |
$4,311.88
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,018.32
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,018.32
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,018.32
|
| Rate for Payer: Brighton Health Commercial |
$7,829.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,311.88
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$4,311.88
|
| Rate for Payer: EmblemHealth Commercial |
$4,311.88
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,880.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,665.10
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,837.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,311.88
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,837.57
|
| Rate for Payer: Group Health Inc Commercial |
$4,311.88
|
| Rate for Payer: Group Health Inc Medicare |
$4,311.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,311.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,685.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$145.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,665.10
|
| Rate for Payer: Healthfirst QHP |
$4,311.88
|
| Rate for Payer: Humana Medicare |
$4,398.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,311.88
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,311.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,311.88
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4,096.29
|
| Rate for Payer: Wellcare Medicare |
$4,096.29
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I
|
Facility
|
IP
|
$5,365.00
|
|
|
Service Code
|
CPT 50435 TC
|
| Hospital Charge Code |
3615043501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,682.50 |
| Max. Negotiated Rate |
$2,682.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,682.50
|
|
|
HC EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I
|
Facility
|
OP
|
$5,365.00
|
|
|
Service Code
|
CPT 50435 TC
|
| Hospital Charge Code |
3615043501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$579.79 |
| Max. Negotiated Rate |
$4,023.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$579.79
|
| Rate for Payer: Aetna Government |
$579.79
|
| Rate for Payer: Brighton Health Commercial |
$4,023.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: EmblemHealth Commercial |
$2,682.50
|
| Rate for Payer: Group Health Inc Commercial |
$2,682.50
|
| Rate for Payer: Group Health Inc Medicare |
$1,877.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,682.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$959.88
|
| Rate for Payer: United Healthcare Commercial |
$1,188.00
|
|
|
HC EXCIS BARTHOLIN GLAND/CYST
|
Facility
|
IP
|
$8,480.00
|
|
|
Service Code
|
CPT 56740
|
| Hospital Charge Code |
3615674001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,240.00 |
| Max. Negotiated Rate |
$4,240.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,240.00
|
|
|
HC EXCIS BARTHOLIN GLAND/CYST
|
Facility
|
OP
|
$8,480.00
|
|
|
Service Code
|
CPT 56740
|
| Hospital Charge Code |
3615674001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$365.13 |
| Max. Negotiated Rate |
$6,360.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| 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 |
$6,360.00
|
| 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 |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$3,884.81
|
| Rate for Payer: EmblemHealth Commercial |
$3,884.81
|
| 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 |
$3,884.81
|
| Rate for Payer: Group Health Inc Medicare |
$3,884.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,884.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,674.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$365.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,302.09
|
| Rate for Payer: Healthfirst QHP |
$3,884.81
|
| Rate for Payer: Humana Medicare |
$3,962.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,884.81
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| 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 EXCISE BENIGN SKIN LESION, FACE/EAR/EYELID/NOSE/LIP, 0.5CM OR LESS
|
Facility
|
IP
|
$1,847.00
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
3611144001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$923.50 |
| Max. Negotiated Rate |
$923.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$923.50
|
|
|
HC EXCISE BENIGN SKIN LESION, FACE/EAR/EYELID/NOSE/LIP, 0.5CM OR LESS
|
Facility
|
OP
|
$1,847.00
|
|
|
Service Code
|
CPT 11440
|
| Hospital Charge Code |
3611144001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$100.27 |
| Max. Negotiated Rate |
$3,092.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$859.66
|
| Rate for Payer: Aetna Government |
$859.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$601.76
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$601.76
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$601.76
|
| Rate for Payer: Brighton Health Commercial |
$1,385.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$859.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$859.66
|
| Rate for Payer: EmblemHealth Commercial |
$859.66
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$773.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$730.71
|
| Rate for Payer: Fidelis Essential Plan QHP |
$765.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$859.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$765.10
|
| Rate for Payer: Group Health Inc Commercial |
$859.66
|
| Rate for Payer: Group Health Inc Medicare |
$859.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$859.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$100.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$124.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$730.71
|
| Rate for Payer: Healthfirst QHP |
$859.66
|
| Rate for Payer: Humana Medicare |
$876.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$859.66
|
| Rate for Payer: United Healthcare Commercial |
$1,188.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$859.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$859.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$816.68
|
| Rate for Payer: Wellcare Medicare |
$816.68
|
|
|
HC EXCISE BENIGN SKIN LESION, FACE/EAR/EYELID/NOSE/LIP, 0.6 TO 1.0CM
|
Facility
|
IP
|
$1,847.00
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
3611144101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$923.50 |
| Max. Negotiated Rate |
$923.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$923.50
|
|
|
HC EXCISE BENIGN SKIN LESION, FACE/EAR/EYELID/NOSE/LIP, 0.6 TO 1.0CM
|
Facility
|
OP
|
$1,847.00
|
|
|
Service Code
|
CPT 11441
|
| Hospital Charge Code |
3611144101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$112.89 |
| Max. Negotiated Rate |
$3,092.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$859.66
|
| Rate for Payer: Aetna Government |
$859.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$601.76
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$601.76
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$601.76
|
| Rate for Payer: Brighton Health Commercial |
$1,385.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$859.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$859.66
|
| Rate for Payer: EmblemHealth Commercial |
$859.66
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$773.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$730.71
|
| Rate for Payer: Fidelis Essential Plan QHP |
$765.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$859.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$765.10
|
| Rate for Payer: Group Health Inc Commercial |
$859.66
|
| Rate for Payer: Group Health Inc Medicare |
$859.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$859.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$112.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$154.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$730.71
|
| Rate for Payer: Healthfirst QHP |
$859.66
|
| Rate for Payer: Humana Medicare |
$876.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$859.66
|
| Rate for Payer: United Healthcare Commercial |
$1,188.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$859.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$859.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$816.68
|
| Rate for Payer: Wellcare Medicare |
$816.68
|
|
|
HC EXCISE BENIGN SKIN LESION, FACE/EAR/EYELID/NOSE/LIP, 1.1 TO 2.0CM
|
Facility
|
OP
|
$1,847.00
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
3611144201
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$123.24 |
| Max. Negotiated Rate |
$3,092.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$859.66
|
| Rate for Payer: Aetna Government |
$859.66
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$601.76
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$601.76
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$601.76
|
| Rate for Payer: Brighton Health Commercial |
$1,385.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$859.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$859.66
|
| Rate for Payer: EmblemHealth Commercial |
$859.66
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$773.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$730.71
|
| Rate for Payer: Fidelis Essential Plan QHP |
$765.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$859.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$765.10
|
| Rate for Payer: Group Health Inc Commercial |
$859.66
|
| Rate for Payer: Group Health Inc Medicare |
$859.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$859.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$123.24
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$171.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$730.71
|
| Rate for Payer: Healthfirst QHP |
$859.66
|
| Rate for Payer: Humana Medicare |
$876.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$859.66
|
| Rate for Payer: United Healthcare Commercial |
$1,188.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$859.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$859.66
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$816.68
|
| Rate for Payer: Wellcare Medicare |
$816.68
|
|
|
HC EXCISE BENIGN SKIN LESION, FACE/EAR/EYELID/NOSE/LIP, 1.1 TO 2.0CM
|
Facility
|
IP
|
$1,847.00
|
|
|
Service Code
|
CPT 11442
|
| Hospital Charge Code |
3611144201
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$923.50 |
| Max. Negotiated Rate |
$923.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$923.50
|
|
|
HC EXCISE BENIGN SKIN LESION, FACE/EAR/EYELID/NOSE/LIP, 2.1 TO 3.0CM
|
Facility
|
OP
|
$4,157.00
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
3611144301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$136.18 |
| Max. Negotiated Rate |
$3,117.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,979.64
|
| Rate for Payer: Aetna Government |
$1,979.64
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,385.75
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,385.75
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,385.75
|
| Rate for Payer: Brighton Health Commercial |
$3,117.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,979.64
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$1,979.64
|
| Rate for Payer: EmblemHealth Commercial |
$1,979.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,781.68
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,682.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,761.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,979.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,761.88
|
| Rate for Payer: Group Health Inc Commercial |
$1,979.64
|
| Rate for Payer: Group Health Inc Medicare |
$1,979.64
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,979.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$136.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$208.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,682.69
|
| Rate for Payer: Healthfirst QHP |
$1,979.64
|
| Rate for Payer: Humana Medicare |
$2,019.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,979.64
|
| Rate for Payer: United Healthcare Commercial |
$1,188.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,979.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,979.64
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,880.66
|
| Rate for Payer: Wellcare Medicare |
$1,880.66
|
|
|
HC EXCISE BENIGN SKIN LESION, FACE/EAR/EYELID/NOSE/LIP, 2.1 TO 3.0CM
|
Facility
|
IP
|
$4,157.00
|
|
|
Service Code
|
CPT 11443
|
| Hospital Charge Code |
3611144301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,078.50 |
| Max. Negotiated Rate |
$2,078.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,078.50
|
|
|
HC EXCISE BENIGN SKIN LESION, FACE/EAR/EYELID/NOSE/LIP, 3.1 TO 4.0CM
|
Facility
|
IP
|
$4,157.00
|
|
|
Service Code
|
CPT 11444
|
| Hospital Charge Code |
3611144401
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,078.50 |
| Max. Negotiated Rate |
$2,078.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,078.50
|
|
