|
CPX4 LOW HI TISSUE 550CC
|
Facility
|
OP
|
$3,662.50
|
|
| Hospital Charge Code |
64903923
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,281.88 |
| Max. Negotiated Rate |
$2,930.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,014.38
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,831.25
|
| Rate for Payer: Aetna Government |
$1,831.25
|
| Rate for Payer: Brighton Health Commercial |
$2,746.88
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,930.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,490.50
|
| Rate for Payer: Group Health Inc Commercial |
$1,831.25
|
| Rate for Payer: Group Health Inc Medicare |
$1,281.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,831.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,831.25
|
|
|
CPX4 MED HT BREAST TISSUE
|
Facility
|
OP
|
$3,662.50
|
|
| Hospital Charge Code |
64904137
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,281.88 |
| Max. Negotiated Rate |
$2,930.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,014.38
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,831.25
|
| Rate for Payer: Aetna Government |
$1,831.25
|
| Rate for Payer: Brighton Health Commercial |
$2,746.88
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,930.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,490.50
|
| Rate for Payer: Group Health Inc Commercial |
$1,831.25
|
| Rate for Payer: Group Health Inc Medicare |
$1,281.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,831.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,831.25
|
|
|
CRADLE HEAD
|
Facility
|
OP
|
$5.85
|
|
| Hospital Charge Code |
64901202
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.05 |
| Max. Negotiated Rate |
$4.68 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.22
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2.92
|
| Rate for Payer: Aetna Government |
$2.92
|
| Rate for Payer: Brighton Health Commercial |
$4.39
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4.68
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$3.98
|
| Rate for Payer: Group Health Inc Commercial |
$2.92
|
| Rate for Payer: Group Health Inc Medicare |
$2.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2.92
|
|
|
CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC
|
Facility
|
IP
|
$38,925.14
|
|
|
Service Code
|
MSDRG 073
|
| Min. Negotiated Rate |
$12,974.00 |
| Max. Negotiated Rate |
$38,925.14 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$22,309.19
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$28,309.19
|
| Rate for Payer: Aetna Government |
$28,309.19
|
| Rate for Payer: Brighton Health Commercial |
$21,938.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$28,875.37
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$26,128.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$21,561.94
|
| Rate for Payer: Elderplan Medicare Advantage |
$26,893.73
|
| Rate for Payer: EmblemHealth Commercial |
$12,974.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$28,309.19
|
| Rate for Payer: Group Health Inc Commercial |
$28,309.19
|
| Rate for Payer: Group Health Inc Medicare |
$28,309.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$28,309.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13,163.77
|
| Rate for Payer: Humana Medicare |
$38,925.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$28,309.19
|
| Rate for Payer: United Healthcare Commercial |
$30,089.03
|
| Rate for Payer: United Healthcare Medicare Advantage |
$28,309.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$28,309.19
|
| Rate for Payer: Wellcare Medicare |
$26,893.73
|
|
|
CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC
|
Facility
|
IP
|
$29,643.01
|
|
|
Service Code
|
MSDRG 074
|
| Min. Negotiated Rate |
$8,799.67 |
| Max. Negotiated Rate |
$29,643.01 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15,131.32
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$21,558.55
|
| Rate for Payer: Aetna Government |
$21,558.55
|
| Rate for Payer: Brighton Health Commercial |
$14,879.90
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$21,989.72
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$17,721.45
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$14,624.50
|
| Rate for Payer: Elderplan Medicare Advantage |
$20,480.62
|
| Rate for Payer: EmblemHealth Commercial |
$8,799.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$21,558.55
|
| Rate for Payer: Group Health Inc Commercial |
$21,558.55
|
| Rate for Payer: Group Health Inc Medicare |
$21,558.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21,558.55
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,024.73
|
| Rate for Payer: Humana Medicare |
$29,643.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$21,558.55
|
| Rate for Payer: United Healthcare Commercial |
$20,408.04
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,558.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21,558.55
|
| Rate for Payer: Wellcare Medicare |
$20,480.62
|
|
|
CRANIAL IMPLANT PSI
|
Facility
|
OP
|
$27,867.50
|
|
| Hospital Charge Code |
64907105
|
|
Hospital Revenue Code
|
279
|
| Min. Negotiated Rate |
$9,753.62 |
| Max. Negotiated Rate |
$22,294.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15,327.12
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$13,933.75
|
| Rate for Payer: Aetna Government |
$13,933.75
|
| Rate for Payer: Brighton Health Commercial |
$20,900.62
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22,294.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$18,949.90
|
| Rate for Payer: Group Health Inc Commercial |
$13,933.75
|
| Rate for Payer: Group Health Inc Medicare |
$9,753.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$13,933.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$13,933.75
|
|
|
CRANIAL MALLEABLE MESH 100X100
|
Facility
|
IP
|
$3,978.00
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40205329
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,989.00 |
| Max. Negotiated Rate |
$1,989.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,989.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,989.00
|
|
|
CRANIAL MALLEABLE MESH 100X100
|
Facility
|
OP
|
$3,978.00
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40205329
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.35 |
| Max. Negotiated Rate |
$4,176.90 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,187.90
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$69.35
|
| Rate for Payer: Aetna Government |
$69.35
|
| Rate for Payer: Brighton Health Commercial |
$2,386.80
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,989.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,287.35
|
| Rate for Payer: EmblemHealth Commercial |
$1,989.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,176.90
|
| Rate for Payer: Group Health Inc Commercial |
$1,989.00
|
| Rate for Payer: Group Health Inc Medicare |
$1,392.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,989.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,989.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,585.70
|
|
|
CRANIAL OPTICAL TUMOR RESECT
|
Facility
|
OP
|
$14,500.00
|
|
| Hospital Charge Code |
64905361
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,075.00 |
| Max. Negotiated Rate |
$11,600.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7,975.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$7,250.00
|
| Rate for Payer: Aetna Government |
$7,250.00
|
| Rate for Payer: Brighton Health Commercial |
$10,875.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$11,600.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9,860.00
|
| Rate for Payer: Group Health Inc Commercial |
$7,250.00
|
| Rate for Payer: Group Health Inc Medicare |
$5,075.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,250.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$7,250.00
|
|
|
CRANIAL PROSTHESIS
|
Facility
|
OP
|
$1,924.00
|
|
|
Service Code
|
HCPCS D5924
|
| Hospital Charge Code |
42301260
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$662.70 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,058.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$662.70
|
| Rate for Payer: Aetna Government |
$662.70
|
| Rate for Payer: Brighton Health Commercial |
$1,443.00
|
| 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 |
$962.00
|
| Rate for Payer: Group Health Inc Medicare |
$673.40
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$962.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$962.00
|
|
|
CRANIAL RIGID MESH 100X100
|
Facility
|
OP
|
$3,978.00
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40205330
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.35 |
| Max. Negotiated Rate |
$4,176.90 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,187.90
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$69.35
|
| Rate for Payer: Aetna Government |
$69.35
|
| Rate for Payer: Brighton Health Commercial |
$2,386.80
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,989.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,287.35
|
| Rate for Payer: EmblemHealth Commercial |
$1,989.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,176.90
|
| Rate for Payer: Group Health Inc Commercial |
$1,989.00
|
| Rate for Payer: Group Health Inc Medicare |
$1,392.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,989.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,989.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,585.70
|
|
|
CRANIAL RIGID MESH 100X100
|
Facility
|
IP
|
$3,978.00
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40205330
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,989.00 |
| Max. Negotiated Rate |
$1,989.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,989.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,989.00
|
|
|
CRANIAL TEMPORAL IMPLANT
|
Facility
|
OP
|
$2,176.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40203018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$2,284.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,196.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
| Rate for Payer: Aetna Government |
$134.20
|
| Rate for Payer: Brighton Health Commercial |
$1,305.60
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,088.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,251.20
|
| Rate for Payer: EmblemHealth Commercial |
$1,088.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,284.80
|
| Rate for Payer: Group Health Inc Commercial |
$1,088.00
|
| Rate for Payer: Group Health Inc Medicare |
$761.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,088.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,088.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,414.40
|
|
|
CRANIAL TEMPORAL IMPLANT
|
Facility
|
IP
|
$2,176.00
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40203018
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,088.00 |
| Max. Negotiated Rate |
$1,088.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,088.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,088.00
|
|
|
CRANIECTOMY EXC. OF TUMOR OR BONE
|
Facility
|
OP
|
$3,756.70
|
|
|
Service Code
|
HCPCS 61500
|
| Hospital Charge Code |
40004296
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,314.84 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,066.18
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,631.65
|
| Rate for Payer: Aetna Government |
$1,631.65
|
| Rate for Payer: Brighton Health Commercial |
$2,817.52
|
| 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: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Group Health Inc Commercial |
$1,878.35
|
| Rate for Payer: Group Health Inc Medicare |
$1,314.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,878.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,878.35
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
|
|
CRANIECTOMY OR CRANIOTOMY DECOMPR
|
Facility
|
OP
|
$6,064.75
|
|
|
Service Code
|
HCPCS 61322
|
| Hospital Charge Code |
40004297
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,496.00 |
| Max. Negotiated Rate |
$4,548.56 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,335.61
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,018.81
|
| Rate for Payer: Aetna Government |
$3,018.81
|
| Rate for Payer: Brighton Health Commercial |
$4,548.56
|
| 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: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Group Health Inc Commercial |
$3,032.38
|
| Rate for Payer: Group Health Inc Medicare |
$2,122.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,032.38
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,032.38
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
CRANIOPLASTY
|
Facility
|
OP
|
$10,331.25
|
|
|
Service Code
|
HCPCS 62120
|
| Hospital Charge Code |
40000540
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,496.00 |
| Max. Negotiated Rate |
$7,748.44 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5,682.19
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,958.84
|
| Rate for Payer: Aetna Government |
$1,958.84
|
| Rate for Payer: Brighton Health Commercial |
$7,748.44
|
| 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: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Group Health Inc Commercial |
$5,165.62
|
| Rate for Payer: Group Health Inc Medicare |
$3,615.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5,165.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5,165.62
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
CRANIOPLASTY DURA
|
Facility
|
OP
|
$4,994.78
|
|
|
Service Code
|
HCPCS 61618
|
| Hospital Charge Code |
40004308
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,496.00 |
| Max. Negotiated Rate |
$3,746.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,747.13
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,612.84
|
| Rate for Payer: Aetna Government |
$1,612.84
|
| Rate for Payer: Brighton Health Commercial |
$3,746.08
|
| 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: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Group Health Inc Commercial |
$2,497.39
|
| Rate for Payer: Group Health Inc Medicare |
$1,748.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,497.39
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,497.39
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
CRANIOPLASTY, SKULL DEFECT, REPAR
|
Facility
|
OP
|
$3,920.45
|
|
|
Service Code
|
HCPCS 62145
|
| Hospital Charge Code |
40004299
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,372.16 |
| Max. Negotiated Rate |
$2,940.34 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,156.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,776.57
|
| Rate for Payer: Aetna Government |
$1,776.57
|
| Rate for Payer: Brighton Health Commercial |
$2,940.34
|
| 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: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Group Health Inc Commercial |
$1,960.22
|
| Rate for Payer: Group Health Inc Medicare |
$1,372.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,960.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,960.22
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
CRANIOPLASTY SYSTEM
|
Facility
|
OP
|
$397.26
|
|
| Hospital Charge Code |
40207029
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$139.04 |
| Max. Negotiated Rate |
$317.81 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$218.49
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$198.63
|
| Rate for Payer: Aetna Government |
$198.63
|
| Rate for Payer: Brighton Health Commercial |
$297.94
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$317.81
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$270.14
|
| Rate for Payer: Group Health Inc Commercial |
$198.63
|
| Rate for Payer: Group Health Inc Medicare |
$139.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$198.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$198.63
|
|
|
CRANIO PLATE #101010
|
Facility
|
OP
|
$10,331.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40201554
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$10,847.81 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5,682.19
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
| Rate for Payer: Aetna Government |
$134.20
|
| Rate for Payer: Brighton Health Commercial |
$6,198.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5,165.62
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$5,940.47
|
| Rate for Payer: EmblemHealth Commercial |
$5,165.62
|
| Rate for Payer: Fidelis Medicare Advantage |
$10,847.81
|
| Rate for Payer: Group Health Inc Commercial |
$5,165.62
|
| Rate for Payer: Group Health Inc Medicare |
$3,615.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5,165.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5,165.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,715.31
|
|
|
CRANIO PLATE #101010
|
Facility
|
IP
|
$10,331.25
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40201554
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,165.62 |
| Max. Negotiated Rate |
$5,165.62 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5,165.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5,165.62
|
|
|
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC
|
Facility
|
IP
|
$66,384.46
|
|
|
Service Code
|
MSDRG 026
|
| Min. Negotiated Rate |
$22,450.02 |
| Max. Negotiated Rate |
$66,384.46 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$43,543.46
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$48,279.61
|
| Rate for Payer: Aetna Government |
$48,279.61
|
| Rate for Payer: Brighton Health Commercial |
$42,819.95
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$49,245.20
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$50,997.08
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$42,084.98
|
| Rate for Payer: Elderplan Medicare Advantage |
$45,865.63
|
| Rate for Payer: EmblemHealth Commercial |
$25,322.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$48,279.61
|
| Rate for Payer: Group Health Inc Commercial |
$48,279.61
|
| Rate for Payer: Group Health Inc Medicare |
$48,279.61
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$48,279.61
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22,450.02
|
| Rate for Payer: Humana Medicare |
$66,384.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$48,279.61
|
| Rate for Payer: United Healthcare Commercial |
$58,728.30
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48,279.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$48,279.61
|
| Rate for Payer: Wellcare Medicare |
$45,865.63
|
|
|
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC
|
Facility
|
IP
|
$94,278.55
|
|
|
Service Code
|
MSDRG 025
|
| Min. Negotiated Rate |
$31,883.29 |
| Max. Negotiated Rate |
$94,278.55 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$65,113.92
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$68,566.22
|
| Rate for Payer: Aetna Government |
$68,566.22
|
| Rate for Payer: Brighton Health Commercial |
$64,032.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$69,937.54
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$76,259.90
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$62,932.95
|
| Rate for Payer: Elderplan Medicare Advantage |
$65,137.91
|
| Rate for Payer: EmblemHealth Commercial |
$37,867.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$68,566.22
|
| Rate for Payer: Group Health Inc Commercial |
$68,566.22
|
| Rate for Payer: Group Health Inc Medicare |
$68,566.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$68,566.22
|
| Rate for Payer: Healthfirst Medicare Advantage |
$31,883.29
|
| Rate for Payer: Humana Medicare |
$94,278.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$68,566.22
|
| Rate for Payer: United Healthcare Commercial |
$87,820.99
|
| Rate for Payer: United Healthcare Medicare Advantage |
$68,566.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$68,566.22
|
| Rate for Payer: Wellcare Medicare |
$65,137.91
|
|
|
CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$56,465.48
|
|
|
Service Code
|
MSDRG 027
|
| Min. Negotiated Rate |
$19,095.60 |
| Max. Negotiated Rate |
$56,465.48 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$35,873.11
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$41,065.80
|
| Rate for Payer: Aetna Government |
$41,065.80
|
| Rate for Payer: Brighton Health Commercial |
$35,277.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$41,887.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$42,013.75
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$34,671.55
|
| Rate for Payer: Elderplan Medicare Advantage |
$39,012.51
|
| Rate for Payer: EmblemHealth Commercial |
$20,862.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$41,065.80
|
| Rate for Payer: Group Health Inc Commercial |
$41,065.80
|
| Rate for Payer: Group Health Inc Medicare |
$41,065.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$41,065.80
|
| Rate for Payer: Healthfirst Medicare Advantage |
$19,095.60
|
| Rate for Payer: Humana Medicare |
$56,465.48
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$41,065.80
|
| Rate for Payer: United Healthcare Commercial |
$48,383.08
|
| Rate for Payer: United Healthcare Medicare Advantage |
$41,065.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$41,065.80
|
| Rate for Payer: Wellcare Medicare |
$39,012.51
|
|
