|
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC
|
Facility
|
IP
|
$158,795.88
|
|
|
Service Code
|
MSDRG 233
|
| Min. Negotiated Rate |
$53,701.88 |
| Max. Negotiated Rate |
$158,795.88 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$115,005.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$115,487.91
|
| Rate for Payer: Aetna Government |
$115,487.91
|
| Rate for Payer: Brighton Health Commercial |
$113,094.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$117,797.67
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$134,691.29
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$111,153.04
|
| Rate for Payer: Elderplan Medicare Advantage |
$109,713.51
|
| Rate for Payer: EmblemHealth Commercial |
$66,881.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$115,487.91
|
| Rate for Payer: Group Health Inc Commercial |
$115,487.91
|
| Rate for Payer: Group Health Inc Medicare |
$115,487.91
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$115,487.91
|
| Rate for Payer: Healthfirst Medicare Advantage |
$53,701.88
|
| Rate for Payer: Humana Medicare |
$158,795.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$115,487.91
|
| Rate for Payer: United Healthcare Commercial |
$155,110.65
|
| Rate for Payer: United Healthcare Medicare Advantage |
$115,487.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$115,487.91
|
| Rate for Payer: Wellcare Medicare |
$109,713.51
|
|
|
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC
|
Facility
|
IP
|
$109,187.54
|
|
|
Service Code
|
MSDRG 234
|
| Min. Negotiated Rate |
$36,925.24 |
| Max. Negotiated Rate |
$109,187.54 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$76,643.04
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$79,409.12
|
| Rate for Payer: Aetna Government |
$79,409.12
|
| Rate for Payer: Brighton Health Commercial |
$75,369.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$80,997.30
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$89,762.54
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$74,075.90
|
| Rate for Payer: Elderplan Medicare Advantage |
$75,438.66
|
| Rate for Payer: EmblemHealth Commercial |
$44,572.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$79,409.12
|
| Rate for Payer: Group Health Inc Commercial |
$79,409.12
|
| Rate for Payer: Group Health Inc Medicare |
$79,409.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$79,409.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$36,925.24
|
| Rate for Payer: Humana Medicare |
$109,187.54
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$79,409.12
|
| Rate for Payer: United Healthcare Commercial |
$103,370.64
|
| Rate for Payer: United Healthcare Medicare Advantage |
$79,409.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$79,409.12
|
| Rate for Payer: Wellcare Medicare |
$75,438.66
|
|
|
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$122,205.05
|
|
|
Service Code
|
MSDRG 235
|
| Min. Negotiated Rate |
$41,327.53 |
| Max. Negotiated Rate |
$122,205.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$86,709.45
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$88,876.40
|
| Rate for Payer: Aetna Government |
$88,876.40
|
| Rate for Payer: Brighton Health Commercial |
$85,268.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$90,653.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$101,552.08
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$83,805.14
|
| Rate for Payer: Elderplan Medicare Advantage |
$84,432.58
|
| Rate for Payer: EmblemHealth Commercial |
$50,426.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$88,876.40
|
| Rate for Payer: Group Health Inc Commercial |
$88,876.40
|
| Rate for Payer: Group Health Inc Medicare |
$88,876.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$88,876.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$41,327.53
|
| Rate for Payer: Humana Medicare |
$122,205.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$88,876.40
|
| Rate for Payer: United Healthcare Commercial |
$116,947.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$88,876.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$88,876.40
|
| Rate for Payer: Wellcare Medicare |
$84,432.58
|
|
|
CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
|
IP
|
$87,131.96
|
|
|
Service Code
|
MSDRG 236
|
| Min. Negotiated Rate |
$29,466.45 |
| Max. Negotiated Rate |
$87,131.96 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$59,587.49
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$63,368.70
|
| Rate for Payer: Aetna Government |
$63,368.70
|
| Rate for Payer: Brighton Health Commercial |
$58,597.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$64,636.07
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$69,787.48
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$57,591.63
|
| Rate for Payer: Elderplan Medicare Advantage |
$60,200.26
|
| Rate for Payer: EmblemHealth Commercial |
$34,653.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$63,368.70
|
| Rate for Payer: Group Health Inc Commercial |
$63,368.70
|
| Rate for Payer: Group Health Inc Medicare |
$63,368.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$63,368.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$29,466.45
|
| Rate for Payer: Humana Medicare |
$87,131.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$63,368.70
|
| Rate for Payer: United Healthcare Commercial |
$80,367.34
|
| Rate for Payer: United Healthcare Medicare Advantage |
$63,368.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$63,368.70
|
| Rate for Payer: Wellcare Medicare |
$60,200.26
|
|
|
CORONARY BYPASS WITH PTCA WITH MCC
|
Facility
|
IP
|
$164,813.60
|
|
|
Service Code
|
MSDRG 231
|
| Min. Negotiated Rate |
$55,736.96 |
| Max. Negotiated Rate |
$164,813.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$119,658.62
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$119,864.44
|
| Rate for Payer: Aetna Government |
$119,864.44
|
| Rate for Payer: Brighton Health Commercial |
$117,670.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$122,261.73
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$140,141.39
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$115,650.69
|
| Rate for Payer: Elderplan Medicare Advantage |
$113,871.22
|
| Rate for Payer: EmblemHealth Commercial |
$69,587.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$119,864.44
|
| Rate for Payer: Group Health Inc Commercial |
$119,864.44
|
| Rate for Payer: Group Health Inc Medicare |
$119,864.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$119,864.44
|
| Rate for Payer: Healthfirst Medicare Advantage |
$55,736.96
|
| Rate for Payer: Humana Medicare |
$164,813.60
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$119,864.44
|
| Rate for Payer: United Healthcare Commercial |
$161,386.98
|
| Rate for Payer: United Healthcare Medicare Advantage |
$119,864.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$119,864.44
|
| Rate for Payer: Wellcare Medicare |
$113,871.22
|
|
|
CORONARY BYPASS WITH PTCA WITHOUT MCC
|
Facility
|
IP
|
$123,501.62
|
|
|
Service Code
|
MSDRG 232
|
| Min. Negotiated Rate |
$41,766.00 |
| Max. Negotiated Rate |
$123,501.62 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$87,712.11
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$89,819.36
|
| Rate for Payer: Aetna Government |
$89,819.36
|
| Rate for Payer: Brighton Health Commercial |
$86,254.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$91,615.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$102,726.37
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$84,774.21
|
| Rate for Payer: Elderplan Medicare Advantage |
$85,328.39
|
| Rate for Payer: EmblemHealth Commercial |
$51,009.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$89,819.36
|
| Rate for Payer: Group Health Inc Commercial |
$89,819.36
|
| Rate for Payer: Group Health Inc Medicare |
$89,819.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$89,819.36
|
| Rate for Payer: Healthfirst Medicare Advantage |
$41,766.00
|
| Rate for Payer: Humana Medicare |
$123,501.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$89,819.36
|
| Rate for Payer: United Healthcare Commercial |
$118,299.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$89,819.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$89,819.36
|
| Rate for Payer: Wellcare Medicare |
$85,328.39
|
|
|
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC
|
Facility
|
IP
|
$89,015.88
|
|
|
Service Code
|
MSDRG 323
|
| Min. Negotiated Rate |
$30,103.55 |
| Max. Negotiated Rate |
$89,015.88 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$61,044.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$64,738.82
|
| Rate for Payer: Aetna Government |
$64,738.82
|
| Rate for Payer: Brighton Health Commercial |
$60,030.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$66,033.60
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$71,493.66
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$58,999.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$61,501.88
|
| Rate for Payer: EmblemHealth Commercial |
$35,500.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$64,738.82
|
| Rate for Payer: Group Health Inc Commercial |
$64,738.82
|
| Rate for Payer: Group Health Inc Medicare |
$64,738.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$64,738.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$30,103.55
|
| Rate for Payer: Humana Medicare |
$89,015.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$64,738.82
|
| Rate for Payer: United Healthcare Commercial |
$82,332.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$64,738.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$64,738.82
|
| Rate for Payer: Wellcare Medicare |
$61,501.88
|
|
|
CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC
|
Facility
|
IP
|
$66,680.03
|
|
|
Service Code
|
MSDRG 324
|
| Min. Negotiated Rate |
$22,549.98 |
| Max. Negotiated Rate |
$66,680.03 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$43,772.01
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$48,494.57
|
| Rate for Payer: Aetna Government |
$48,494.57
|
| Rate for Payer: Brighton Health Commercial |
$43,044.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$49,464.46
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51,264.75
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$42,305.87
|
| Rate for Payer: Elderplan Medicare Advantage |
$46,069.84
|
| Rate for Payer: EmblemHealth Commercial |
$25,455.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$48,494.57
|
| Rate for Payer: Group Health Inc Commercial |
$48,494.57
|
| Rate for Payer: Group Health Inc Medicare |
$48,494.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$48,494.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22,549.98
|
| Rate for Payer: Humana Medicare |
$66,680.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$48,494.57
|
| Rate for Payer: United Healthcare Commercial |
$59,036.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48,494.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$48,494.57
|
| Rate for Payer: Wellcare Medicare |
$46,069.84
|
|
|
CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE
|
Facility
|
IP
|
$60,496.40
|
|
|
Service Code
|
MSDRG 325
|
| Min. Negotiated Rate |
$20,458.78 |
| Max. Negotiated Rate |
$60,496.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$38,990.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$43,997.38
|
| Rate for Payer: Aetna Government |
$43,997.38
|
| Rate for Payer: Brighton Health Commercial |
$38,342.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$44,877.33
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$45,664.42
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$37,684.24
|
| Rate for Payer: Elderplan Medicare Advantage |
$41,797.51
|
| Rate for Payer: EmblemHealth Commercial |
$22,674.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$43,997.38
|
| Rate for Payer: Group Health Inc Commercial |
$43,997.38
|
| Rate for Payer: Group Health Inc Medicare |
$43,997.38
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$43,997.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$20,458.78
|
| Rate for Payer: Humana Medicare |
$60,496.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$43,997.38
|
| Rate for Payer: United Healthcare Commercial |
$52,587.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$43,997.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$43,997.38
|
| Rate for Payer: Wellcare Medicare |
$41,797.51
|
|
|
CORONAVIRUS/COVID-19 TEST
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
HCPCS U0002
|
| Hospital Charge Code |
40601999
|
|
Hospital Revenue Code
|
306
|
| Rate for Payer: Cash Price |
$51.31
|
|
|
CORONAVIRUS/COVID-19 TEST
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
HCPCS U0002
|
| Hospital Charge Code |
40601999
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$52.34 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$28.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$51.31
|
| Rate for Payer: Aetna Government |
$51.31
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$35.92
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$35.92
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$35.92
|
| Rate for Payer: Brighton Health Commercial |
$39.00
|
| Rate for Payer: Cash Price |
$51.31
|
| Rate for Payer: Cash Price |
$51.31
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$51.31
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$41.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$35.36
|
| Rate for Payer: Elderplan Medicare Advantage |
$51.31
|
| Rate for Payer: EmblemHealth Commercial |
$51.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$43.61
|
| Rate for Payer: Fidelis Essential Plan QHP |
$45.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$51.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$45.67
|
| Rate for Payer: Group Health Inc Commercial |
$51.31
|
| Rate for Payer: Group Health Inc Medicare |
$51.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$51.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$43.61
|
| Rate for Payer: Healthfirst QHP |
$51.31
|
| Rate for Payer: Humana Medicare |
$52.34
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$51.31
|
| Rate for Payer: United Healthcare Commercial |
$46.18
|
| Rate for Payer: United Healthcare Medicare Advantage |
$51.31
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$51.31
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$41.05
|
| Rate for Payer: Wellcare Medicare |
$46.18
|
|
|
CORONECTOMY-PART TOOTH REMOVAL
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
HCPCS D7251
|
| Hospital Charge Code |
42300746
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$247.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,763.60
|
| Rate for Payer: Aetna Government |
$1,763.60
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,234.52
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,234.52
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,234.52
|
| Rate for Payer: Brighton Health Commercial |
$337.50
|
| Rate for Payer: Cash Price |
$1,763.60
|
| Rate for Payer: Cash Price |
$1,763.60
|
| Rate for Payer: Cash Price |
$1,763.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,763.60
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$1,763.60
|
| Rate for Payer: EmblemHealth Commercial |
$1,763.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,499.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,569.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,763.60
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,569.60
|
| Rate for Payer: Group Health Inc Commercial |
$1,763.60
|
| Rate for Payer: Group Health Inc Medicare |
$1,763.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$225.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,763.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,499.06
|
| Rate for Payer: Healthfirst QHP |
$1,763.60
|
| Rate for Payer: Humana Medicare |
$1,798.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,763.60
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,763.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,763.60
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,410.88
|
| Rate for Payer: Wellcare Medicare |
$1,675.42
|
|
|
CORONECTOMY-PART TOOTH REMOVAL
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
HCPCS D7251
|
| Hospital Charge Code |
42300746
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$1,763.60
|
|
|
CORONOIDECTOMY
|
Facility
|
OP
|
$1,377.50
|
|
|
Service Code
|
HCPCS D7991
|
| Hospital Charge Code |
42302160
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$482.12 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$757.62
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,101.83
|
| Rate for Payer: Aetna Government |
$1,101.83
|
| Rate for Payer: Brighton Health Commercial |
$1,033.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Group Health Inc Commercial |
$688.75
|
| Rate for Payer: Group Health Inc Medicare |
$482.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$688.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$688.75
|
|
|
CORRECT BUNION BY DOUBLE OSTEOTOM
|
Facility
|
OP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 28299
|
| Hospital Charge Code |
40019903
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$13,588.37 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8,273.12
|
| Rate for Payer: Aetna Government |
$8,273.12
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5,791.18
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5,791.18
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5,791.18
|
| Rate for Payer: Brighton Health Commercial |
$13,588.37
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8,273.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$8,273.12
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7,032.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7,363.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$8,273.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7,363.08
|
| Rate for Payer: Group Health Inc Commercial |
$8,273.12
|
| Rate for Payer: Group Health Inc Medicare |
$8,273.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9,058.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8,273.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,032.15
|
| Rate for Payer: Healthfirst QHP |
$8,273.12
|
| Rate for Payer: Humana Medicare |
$8,438.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8,273.12
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,273.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8,273.12
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6,618.50
|
| Rate for Payer: Wellcare Medicare |
$7,859.46
|
|
|
CORRECT BUNION BY DOUBLE OSTEOTOM
|
Facility
|
IP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 28299
|
| Hospital Charge Code |
40019903
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$8,273.12
|
|
|
CORRECT BUNION BY PHALANX OSTEOTO
|
Facility
|
OP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 28298
|
| Hospital Charge Code |
40019902
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$13,588.37 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8,273.12
|
| Rate for Payer: Aetna Government |
$8,273.12
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5,791.18
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5,791.18
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5,791.18
|
| Rate for Payer: Brighton Health Commercial |
$13,588.37
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8,273.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$8,273.12
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7,032.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7,363.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$8,273.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7,363.08
|
| Rate for Payer: Group Health Inc Commercial |
$8,273.12
|
| Rate for Payer: Group Health Inc Medicare |
$8,273.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9,058.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8,273.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,032.15
|
| Rate for Payer: Healthfirst QHP |
$8,273.12
|
| Rate for Payer: Humana Medicare |
$8,438.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8,273.12
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,273.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8,273.12
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6,618.50
|
| Rate for Payer: Wellcare Medicare |
$7,859.46
|
|
|
CORRECT BUNION BY PHALANX OSTEOTO
|
Facility
|
IP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 28298
|
| Hospital Charge Code |
40019902
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$8,273.12
|
|
|
CORRECT BUNION W RESECT OF JOINT
|
Facility
|
IP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 28291
|
| Hospital Charge Code |
40019901
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$8,273.12
|
|
|
CORRECT BUNION W RESECT OF JOINT
|
Facility
|
OP
|
$18,117.83
|
|
|
Service Code
|
HCPCS 28291
|
| Hospital Charge Code |
40019901
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$13,588.37 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$8,273.12
|
| Rate for Payer: Aetna Government |
$8,273.12
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5,791.18
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5,791.18
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5,791.18
|
| Rate for Payer: Brighton Health Commercial |
$13,588.37
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Cash Price |
$8,273.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$8,273.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$8,273.12
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7,032.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7,363.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$8,273.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7,363.08
|
| Rate for Payer: Group Health Inc Commercial |
$8,273.12
|
| Rate for Payer: Group Health Inc Medicare |
$8,273.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9,058.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8,273.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,032.15
|
| Rate for Payer: Healthfirst QHP |
$8,273.12
|
| Rate for Payer: Humana Medicare |
$8,438.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8,273.12
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$8,273.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8,273.12
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6,618.50
|
| Rate for Payer: Wellcare Medicare |
$7,859.46
|
|
|
CORRECTION HALLUX VALGUS
|
Facility
|
IP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 28292
|
| Hospital Charge Code |
40021495
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,743.15
|
|
|
CORRECTION HALLUX VALGUS
|
Facility
|
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 28292
|
| Hospital Charge Code |
40021495
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$6,218.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,743.15
|
| Rate for Payer: Aetna Government |
$3,743.15
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,620.20
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,620.20
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,620.20
|
| Rate for Payer: Brighton Health Commercial |
$6,218.29
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,743.15
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$3,743.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,181.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,331.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,743.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,331.40
|
| Rate for Payer: Group Health Inc Commercial |
$3,743.15
|
| Rate for Payer: Group Health Inc Medicare |
$3,743.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,145.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,743.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Humana Medicare |
$3,818.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,743.15
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,743.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,743.15
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,994.52
|
| Rate for Payer: Wellcare Medicare |
$3,555.99
|
|
|
Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method
|
Facility
|
OP
|
$3,818.01
|
|
|
Service Code
|
CPT 28296
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$3,818.01 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,743.15
|
| Rate for Payer: Aetna Government |
$3,743.15
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,620.20
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,620.20
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,620.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,743.15
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$3,743.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,181.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,331.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,743.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,331.40
|
| Rate for Payer: Group Health Inc Commercial |
$3,743.15
|
| Rate for Payer: Group Health Inc Medicare |
$3,743.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,743.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Humana Medicare |
$3,818.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,743.15
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,743.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,743.15
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,994.52
|
| Rate for Payer: Wellcare Medicare |
$3,555.99
|
|
|
Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with resection of proximal phalanx base, when performed, any method
|
Facility
|
OP
|
$3,818.01
|
|
|
Service Code
|
CPT 28292
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$3,818.01 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,743.15
|
| Rate for Payer: Aetna Government |
$3,743.15
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,620.20
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,620.20
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,620.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,743.15
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$3,743.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,181.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,331.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,743.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,331.40
|
| Rate for Payer: Group Health Inc Commercial |
$3,743.15
|
| Rate for Payer: Group Health Inc Medicare |
$3,743.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,743.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Humana Medicare |
$3,818.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,743.15
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,743.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,743.15
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,994.52
|
| Rate for Payer: Wellcare Medicare |
$3,555.99
|
|
|
Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)
|
Facility
|
OP
|
$3,818.01
|
|
|
Service Code
|
CPT 28285
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$3,818.01 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,743.15
|
| Rate for Payer: Aetna Government |
$3,743.15
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,620.20
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,620.20
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,620.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,743.15
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,915.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,477.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$3,743.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,181.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,331.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,743.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,331.40
|
| Rate for Payer: Group Health Inc Commercial |
$3,743.15
|
| Rate for Payer: Group Health Inc Medicare |
$3,743.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,743.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Humana Medicare |
$3,818.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,743.15
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,743.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,743.15
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,994.52
|
| Rate for Payer: Wellcare Medicare |
$3,555.99
|
|
