|
HC EXCISE MALGNT SKIN LESION, SCALP/NECK/HANDS/FT/GEN, 3.1 TO 4.0CM
|
Facility
|
OP
|
$4,157.00
|
|
|
Service Code
|
CPT 11624
|
| Hospital Charge Code |
3611162401
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$273.45 |
| Max. Negotiated Rate |
$3,117.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| 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 |
$708.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$273.45
|
| 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 |
$1,409.00
|
| 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 MALGNT SKIN LESION, SCALP/NECK/HANDS/FT/GEN, >4.0CM
|
Facility
|
IP
|
$7,023.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
3611162601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,511.50 |
| Max. Negotiated Rate |
$3,511.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,511.50
|
|
|
HC EXCISE MALGNT SKIN LESION, SCALP/NECK/HANDS/FT/GEN, >4.0CM
|
Facility
|
OP
|
$7,023.00
|
|
|
Service Code
|
CPT 11626
|
| Hospital Charge Code |
3611162601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$337.22 |
| Max. Negotiated Rate |
$5,267.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,496.91
|
| Rate for Payer: Aetna Government |
$3,496.91
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,447.84
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,447.84
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,447.84
|
| Rate for Payer: Brighton Health Commercial |
$5,267.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,496.91
|
| 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 |
$3,496.91
|
| Rate for Payer: EmblemHealth Commercial |
$3,496.91
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,147.22
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,972.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,112.25
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,496.91
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,112.25
|
| Rate for Payer: Group Health Inc Commercial |
$3,496.91
|
| Rate for Payer: Group Health Inc Medicare |
$3,496.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,496.91
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,201.90
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$337.22
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,972.37
|
| Rate for Payer: Healthfirst QHP |
$3,496.91
|
| Rate for Payer: Humana Medicare |
$3,566.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,496.91
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,496.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,496.91
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,322.06
|
| Rate for Payer: Wellcare Medicare |
$3,322.06
|
|
|
HC EXCISE MALGNT SKIN LESION, TRUCK/ARMS/LEGS, 0.5CM OR LESS
|
Facility
|
IP
|
$1,847.00
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
3611160001
|
|
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 MALGNT SKIN LESION, TRUCK/ARMS/LEGS, 0.5CM OR LESS
|
Facility
|
OP
|
$1,847.00
|
|
|
Service Code
|
CPT 11600
|
| Hospital Charge Code |
3611160001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$131.65 |
| 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 |
$131.65
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$140.94
|
| 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 MALGNT SKIN LESION, TRUCK/ARMS/LEGS, 0.6 TO 1.0CM
|
Facility
|
OP
|
$1,847.00
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
3611160101
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$146.53 |
| 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 |
$146.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$170.61
|
| 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 MALGNT SKIN LESION, TRUCK/ARMS/LEGS, 0.6 TO 1.0CM
|
Facility
|
IP
|
$1,847.00
|
|
|
Service Code
|
CPT 11601
|
| Hospital Charge Code |
3611160101
|
|
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 MALGNT SKIN LESION, TRUCK/ARMS/LEGS, 1.1 TO 2.0CM
|
Facility
|
OP
|
$967.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
3611160201
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$156.23 |
| Max. Negotiated Rate |
$3,092.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$488.15
|
| Rate for Payer: Aetna Government |
$488.15
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$341.70
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$341.70
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$341.70
|
| Rate for Payer: Brighton Health Commercial |
$725.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$488.15
|
| 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 |
$488.15
|
| Rate for Payer: EmblemHealth Commercial |
$488.15
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$439.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$414.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$434.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$488.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$434.45
|
| Rate for Payer: Group Health Inc Commercial |
$488.15
|
| Rate for Payer: Group Health Inc Medicare |
$488.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$488.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$156.23
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$184.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$414.93
|
| Rate for Payer: Healthfirst QHP |
$488.15
|
| Rate for Payer: Humana Medicare |
$497.91
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$488.15
|
| Rate for Payer: United Healthcare Commercial |
$1,113.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$488.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$488.15
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$463.74
|
| Rate for Payer: Wellcare Medicare |
$463.74
|
|
|
HC EXCISE MALGNT SKIN LESION, TRUCK/ARMS/LEGS, 1.1 TO 2.0CM
|
Facility
|
IP
|
$967.00
|
|
|
Service Code
|
CPT 11602
|
| Hospital Charge Code |
3611160201
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$483.50 |
| Max. Negotiated Rate |
$483.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$483.50
|
|
|
HC EXCISE MALGNT SKIN LESION, TRUCK/ARMS/LEGS, 2.1 TO 3.0CM
|
Facility
|
IP
|
$1,847.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
3611160301
|
|
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 MALGNT SKIN LESION, TRUCK/ARMS/LEGS, 2.1 TO 3.0CM
|
Facility
|
OP
|
$1,847.00
|
|
|
Service Code
|
CPT 11603
|
| Hospital Charge Code |
3611160301
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$168.85 |
| 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 |
$168.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$221.41
|
| 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 MALGNT SKIN LESION, TRUCK/ARMS/LEGS, 3.1 TO 4.0CM
|
Facility
|
IP
|
$1,847.00
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
3611160401
|
|
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 MALGNT SKIN LESION, TRUCK/ARMS/LEGS, 3.1 TO 4.0CM
|
Facility
|
OP
|
$1,847.00
|
|
|
Service Code
|
CPT 11604
|
| Hospital Charge Code |
3611160401
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$244.86 |
| Max. Negotiated Rate |
$3,092.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| 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 |
$377.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$244.86
|
| 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 MALGNT SKIN LESION, TRUCK/ARMS/LEGS, >4.0CM
|
Facility
|
IP
|
$4,157.00
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
3611160601
|
|
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 MALGNT SKIN LESION, TRUCK/ARMS/LEGS, >4.0CM
|
Facility
|
OP
|
$4,157.00
|
|
|
Service Code
|
CPT 11606
|
| Hospital Charge Code |
3611160601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$366.38 |
| Max. Negotiated Rate |
$3,117.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| 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 |
$708.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$366.38
|
| 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 |
$1,409.00
|
| 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 EXCISION/DESTRUCTION OPEN ABDOMINAL TUMORS 5.1-10.0 CM
|
Facility
|
OP
|
$10,563.00
|
|
|
Service Code
|
CPT 49204
|
| Hospital Charge Code |
3614920401
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,808.83 |
| Max. Negotiated Rate |
$7,922.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5,809.65
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,808.83
|
| Rate for Payer: Aetna Government |
$1,808.83
|
| Rate for Payer: Brighton Health Commercial |
$7,922.25
|
| 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 |
$5,281.50
|
| Rate for Payer: Group Health Inc Commercial |
$5,281.50
|
| Rate for Payer: Group Health Inc Medicare |
$3,697.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5,281.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5,281.50
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
|
|
HC EXCISION/DESTRUCTION OPEN ABDOMINAL TUMORS 5.1-10.0 CM
|
Facility
|
IP
|
$10,563.00
|
|
|
Service Code
|
CPT 49204
|
| Hospital Charge Code |
3614920401
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,281.50 |
| Max. Negotiated Rate |
$5,281.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5,281.50
|
|
|
HC EXCISION MULT PAPILLAE/TAGS, ANUS
|
Facility
|
IP
|
$7,099.00
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
5104623001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$3,549.50 |
| Max. Negotiated Rate |
$3,549.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,549.50
|
|
|
HC EXCISION MULT PAPILLAE/TAGS, ANUS
|
Facility
|
OP
|
$7,099.00
|
|
|
Service Code
|
CPT 46230
|
| Hospital Charge Code |
5104623001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$184.48 |
| Max. Negotiated Rate |
$3,518.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,350.71
|
| Rate for Payer: Aetna Government |
$3,350.71
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,345.50
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,345.50
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,345.50
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,350.71
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$217.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$184.48
|
| Rate for Payer: Elderplan Medicare Advantage |
$3,350.71
|
| Rate for Payer: EmblemHealth Commercial |
$250.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,015.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,848.10
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,982.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,350.71
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,982.13
|
| 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 |
$3,350.71
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,397.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$205.16
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,848.10
|
| Rate for Payer: Healthfirst QHP |
$3,350.71
|
| Rate for Payer: Humana Medicare |
$3,417.72
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,518.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,350.71
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,350.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,350.71
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,183.17
|
| Rate for Payer: Wellcare Medicare |
$3,183.17
|
|
|
HC EXCISION OF ANAL LESION
|
Facility
|
OP
|
$7,520.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
3614692201
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$162.97 |
| Max. Negotiated Rate |
$5,640.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,350.71
|
| Rate for Payer: Aetna Government |
$3,350.71
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,345.50
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,345.50
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,345.50
|
| Rate for Payer: Brighton Health Commercial |
$5,640.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,350.71
|
| 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 |
$3,350.71
|
| Rate for Payer: EmblemHealth Commercial |
$3,350.71
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,015.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,848.10
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,982.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,350.71
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,982.13
|
| Rate for Payer: Group Health Inc Commercial |
$3,350.71
|
| Rate for Payer: Group Health Inc Medicare |
$3,350.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,350.71
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,397.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$162.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,848.10
|
| Rate for Payer: Healthfirst QHP |
$3,350.71
|
| Rate for Payer: Humana Medicare |
$3,417.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,350.71
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,350.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,350.71
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,183.17
|
| Rate for Payer: Wellcare Medicare |
$3,183.17
|
|
|
HC EXCISION OF ANAL LESION
|
Facility
|
IP
|
$7,520.00
|
|
|
Service Code
|
CPT 46922
|
| Hospital Charge Code |
3614692201
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,760.00 |
| Max. Negotiated Rate |
$3,760.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,760.00
|
|
|
HC EXCISION OF CHALAZION
|
Facility
|
OP
|
$847.00
|
|
|
Service Code
|
CPT 67800
|
| Hospital Charge Code |
5106780001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$75.69 |
| Max. Negotiated Rate |
$780.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$365.24
|
| Rate for Payer: Aetna Government |
$365.24
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$255.67
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$255.67
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$255.67
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$365.24
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$217.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$184.48
|
| Rate for Payer: Elderplan Medicare Advantage |
$365.24
|
| Rate for Payer: EmblemHealth Commercial |
$250.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$328.72
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$310.45
|
| Rate for Payer: Fidelis Essential Plan QHP |
$325.06
|
| Rate for Payer: Fidelis Medicare Advantage |
$365.24
|
| Rate for Payer: Fidelis Qualified Health Plan |
$325.06
|
| 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 |
$365.24
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$75.69
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$115.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$310.45
|
| Rate for Payer: Healthfirst QHP |
$365.24
|
| Rate for Payer: Humana Medicare |
$372.54
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$383.50
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$365.24
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$365.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$365.24
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$346.98
|
| Rate for Payer: Wellcare Medicare |
$346.98
|
|
|
HC EXCISION OF CHALAZION
|
Facility
|
IP
|
$847.00
|
|
|
Service Code
|
CPT 67800
|
| Hospital Charge Code |
5106780001
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$423.50 |
| Max. Negotiated Rate |
$423.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$423.50
|
|
|
HC EXCISION OF NAIL FOLD TOE
|
Facility
|
OP
|
$967.00
|
|
|
Service Code
|
CPT 11765
|
| Hospital Charge Code |
3611176501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$106.43 |
| Max. Negotiated Rate |
$3,092.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$488.15
|
| Rate for Payer: Aetna Government |
$488.15
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$341.70
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$341.70
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$341.70
|
| Rate for Payer: Brighton Health Commercial |
$725.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$488.15
|
| 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 |
$488.15
|
| Rate for Payer: EmblemHealth Commercial |
$488.15
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$439.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$414.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$434.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$488.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$434.45
|
| Rate for Payer: Group Health Inc Commercial |
$488.15
|
| Rate for Payer: Group Health Inc Medicare |
$488.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$488.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$488.15
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$106.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$414.93
|
| Rate for Payer: Healthfirst QHP |
$488.15
|
| Rate for Payer: Humana Medicare |
$497.91
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$488.15
|
| Rate for Payer: United Healthcare Commercial |
$1,113.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$488.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$488.15
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$463.74
|
| Rate for Payer: Wellcare Medicare |
$463.74
|
|
|
HC EXCISION OF NAIL FOLD TOE
|
Facility
|
IP
|
$967.00
|
|
|
Service Code
|
CPT 11765
|
| Hospital Charge Code |
3611176501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$483.50 |
| Max. Negotiated Rate |
$483.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$483.50
|
|
