|
CRANIOTOMY - BIFRONTAL
|
Facility
|
OP
|
$4,848.98
|
|
|
Service Code
|
HCPCS 61557
|
| Hospital Charge Code |
40004295
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,496.00 |
| Max. Negotiated Rate |
$3,636.74 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,666.94
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,997.66
|
| Rate for Payer: Aetna Government |
$1,997.66
|
| Rate for Payer: Brighton Health Commercial |
$3,636.74
|
| 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 |
$2,424.49
|
| Rate for Payer: Group Health Inc Medicare |
$1,697.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,424.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,424.49
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
CRANIOTOMY DECOMPRESSIVE W LOBECT
|
Facility
|
OP
|
$6,357.80
|
|
|
Service Code
|
HCPCS 61323
|
| Hospital Charge Code |
40004298
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,496.00 |
| Max. Negotiated Rate |
$4,768.35 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,496.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,064.81
|
| Rate for Payer: Aetna Government |
$3,064.81
|
| Rate for Payer: Brighton Health Commercial |
$4,768.35
|
| 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 |
$3,178.90
|
| Rate for Payer: Group Health Inc Medicare |
$2,225.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,178.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,178.90
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
CRANIOTOMY DRAINAGE CEREBRAL ABS
|
Facility
|
OP
|
$5,873.95
|
|
|
Service Code
|
HCPCS 61320
|
| Hospital Charge Code |
40003188
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,496.00 |
| Max. Negotiated Rate |
$4,405.46 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,230.67
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,409.14
|
| Rate for Payer: Aetna Government |
$2,409.14
|
| Rate for Payer: Brighton Health Commercial |
$4,405.46
|
| 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 |
$2,936.98
|
| Rate for Payer: Group Health Inc Medicare |
$2,055.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,936.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,936.98
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA
|
Facility
|
IP
|
$126,201.62
|
|
|
Service Code
|
MSDRG 955
|
| Min. Negotiated Rate |
$42,679.10 |
| Max. Negotiated Rate |
$126,201.62 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$89,800.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$91,783.00
|
| Rate for Payer: Aetna Government |
$91,783.00
|
| Rate for Payer: Brighton Health Commercial |
$88,307.90
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$93,618.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$105,171.66
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$86,792.17
|
| Rate for Payer: Elderplan Medicare Advantage |
$87,193.85
|
| Rate for Payer: EmblemHealth Commercial |
$52,223.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$91,783.00
|
| Rate for Payer: Group Health Inc Commercial |
$91,783.00
|
| Rate for Payer: Group Health Inc Medicare |
$91,783.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$91,783.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$42,679.10
|
| Rate for Payer: Humana Medicare |
$126,201.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$91,783.00
|
| Rate for Payer: United Healthcare Commercial |
$121,115.81
|
| Rate for Payer: United Healthcare Medicare Advantage |
$91,783.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$91,783.00
|
| Rate for Payer: Wellcare Medicare |
$87,193.85
|
|
|
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR
|
Facility
|
IP
|
$118,166.51
|
|
|
Service Code
|
MSDRG 023
|
| Min. Negotiated Rate |
$39,961.77 |
| Max. Negotiated Rate |
$118,166.51 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$83,586.46
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$85,939.28
|
| Rate for Payer: Aetna Government |
$85,939.28
|
| Rate for Payer: Brighton Health Commercial |
$82,197.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$87,658.07
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$97,894.51
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$80,786.75
|
| Rate for Payer: Elderplan Medicare Advantage |
$81,642.32
|
| Rate for Payer: EmblemHealth Commercial |
$48,610.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$85,939.28
|
| Rate for Payer: Group Health Inc Commercial |
$85,939.28
|
| Rate for Payer: Group Health Inc Medicare |
$85,939.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$85,939.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$39,961.77
|
| Rate for Payer: Humana Medicare |
$118,166.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$85,939.28
|
| Rate for Payer: United Healthcare Commercial |
$112,735.43
|
| Rate for Payer: United Healthcare Medicare Advantage |
$85,939.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$85,939.28
|
| Rate for Payer: Wellcare Medicare |
$81,642.32
|
|
|
CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC
|
Facility
|
IP
|
$82,319.31
|
|
|
Service Code
|
MSDRG 024
|
| Min. Negotiated Rate |
$27,838.89 |
| Max. Negotiated Rate |
$82,319.31 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$55,865.86
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$59,868.59
|
| Rate for Payer: Aetna Government |
$59,868.59
|
| Rate for Payer: Brighton Health Commercial |
$54,937.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$61,065.96
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$65,428.79
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$53,994.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$56,875.16
|
| Rate for Payer: EmblemHealth Commercial |
$32,489.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$59,868.59
|
| Rate for Payer: Group Health Inc Commercial |
$59,868.59
|
| Rate for Payer: Group Health Inc Medicare |
$59,868.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$59,868.59
|
| Rate for Payer: Healthfirst Medicare Advantage |
$27,838.89
|
| Rate for Payer: Humana Medicare |
$82,319.31
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$59,868.59
|
| Rate for Payer: United Healthcare Commercial |
$75,347.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$59,868.59
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$59,868.59
|
| Rate for Payer: Wellcare Medicare |
$56,875.16
|
|
|
C-REACIVE PROTEIN
|
Facility
|
IP
|
$12.95
|
|
|
Service Code
|
HCPCS 86140
|
| Hospital Charge Code |
40614080
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$5.18
|
|
|
C-REACIVE PROTEIN
|
Facility
|
OP
|
$12.95
|
|
|
Service Code
|
HCPCS 86140
|
| Hospital Charge Code |
40614080
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$9.71 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.12
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.18
|
| Rate for Payer: Aetna Government |
$5.18
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.63
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.63
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.63
|
| Rate for Payer: Brighton Health Commercial |
$9.71
|
| Rate for Payer: Cash Price |
$5.18
|
| Rate for Payer: Cash Price |
$5.18
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.18
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.23
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.96
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.18
|
| Rate for Payer: EmblemHealth Commercial |
$5.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.61
|
| Rate for Payer: Group Health Inc Commercial |
$5.18
|
| Rate for Payer: Group Health Inc Medicare |
$5.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.18
|
| Rate for Payer: Healthfirst QHP |
$5.18
|
| Rate for Payer: Humana Medicare |
$5.28
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.18
|
| Rate for Payer: United Healthcare Commercial |
$6.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.18
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.18
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.14
|
| Rate for Payer: Wellcare Medicare |
$4.66
|
|
|
C-REACTIVE PROTEIN CARDIAC
|
Facility
|
IP
|
$32.38
|
|
|
Service Code
|
HCPCS 86141
|
| Hospital Charge Code |
40609742
|
|
Hospital Revenue Code
|
302
|
| Rate for Payer: Cash Price |
$12.95
|
|
|
C-REACTIVE PROTEIN CARDIAC
|
Facility
|
OP
|
$32.38
|
|
|
Service Code
|
HCPCS 86141
|
| Hospital Charge Code |
40609742
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.06 |
| Max. Negotiated Rate |
$24.28 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.81
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.95
|
| Rate for Payer: Aetna Government |
$12.95
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$9.06
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$9.06
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$9.06
|
| Rate for Payer: Brighton Health Commercial |
$24.28
|
| Rate for Payer: Cash Price |
$12.95
|
| Rate for Payer: Cash Price |
$12.95
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12.95
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.41
|
| Rate for Payer: Elderplan Medicare Advantage |
$12.95
|
| Rate for Payer: EmblemHealth Commercial |
$12.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$11.01
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.53
|
| Rate for Payer: Fidelis Medicare Advantage |
$12.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.53
|
| Rate for Payer: Group Health Inc Commercial |
$12.95
|
| Rate for Payer: Group Health Inc Medicare |
$12.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12.95
|
| Rate for Payer: Healthfirst QHP |
$12.95
|
| Rate for Payer: Humana Medicare |
$13.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12.95
|
| Rate for Payer: United Healthcare Commercial |
$16.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12.95
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10.36
|
| Rate for Payer: Wellcare Medicare |
$11.66
|
|
|
C-REACTIVE PROTEIN, QUANT
|
Facility
|
IP
|
$12.95
|
|
|
Service Code
|
HCPCS 86140
|
| Hospital Charge Code |
40609135
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$5.18
|
|
|
C-REACTIVE PROTEIN, QUANT
|
Facility
|
OP
|
$12.95
|
|
|
Service Code
|
HCPCS 86140
|
| Hospital Charge Code |
40609135
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$9.71 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.12
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.18
|
| Rate for Payer: Aetna Government |
$5.18
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.63
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.63
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.63
|
| Rate for Payer: Brighton Health Commercial |
$9.71
|
| Rate for Payer: Cash Price |
$5.18
|
| Rate for Payer: Cash Price |
$5.18
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.18
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.23
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.96
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.18
|
| Rate for Payer: EmblemHealth Commercial |
$5.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.61
|
| Rate for Payer: Group Health Inc Commercial |
$5.18
|
| Rate for Payer: Group Health Inc Medicare |
$5.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.18
|
| Rate for Payer: Healthfirst QHP |
$5.18
|
| Rate for Payer: Humana Medicare |
$5.28
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.18
|
| Rate for Payer: United Healthcare Commercial |
$6.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.18
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.18
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.14
|
| Rate for Payer: Wellcare Medicare |
$4.66
|
|
|
C-REACTIVE PROTEIN QUANTITATIVE
|
Facility
|
IP
|
$32.38
|
|
|
Service Code
|
HCPCS 86141
|
| Hospital Charge Code |
40604486
|
|
Hospital Revenue Code
|
301
|
| Rate for Payer: Cash Price |
$12.95
|
|
|
C-REACTIVE PROTEIN QUANTITATIVE
|
Facility
|
OP
|
$32.38
|
|
|
Service Code
|
HCPCS 86141
|
| Hospital Charge Code |
40604486
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.06 |
| Max. Negotiated Rate |
$24.28 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.81
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.95
|
| Rate for Payer: Aetna Government |
$12.95
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$9.06
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$9.06
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$9.06
|
| Rate for Payer: Brighton Health Commercial |
$24.28
|
| Rate for Payer: Cash Price |
$12.95
|
| Rate for Payer: Cash Price |
$12.95
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12.95
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.41
|
| Rate for Payer: Elderplan Medicare Advantage |
$12.95
|
| Rate for Payer: EmblemHealth Commercial |
$12.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$11.01
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.53
|
| Rate for Payer: Fidelis Medicare Advantage |
$12.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.53
|
| Rate for Payer: Group Health Inc Commercial |
$12.95
|
| Rate for Payer: Group Health Inc Medicare |
$12.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12.95
|
| Rate for Payer: Healthfirst QHP |
$12.95
|
| Rate for Payer: Humana Medicare |
$13.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12.95
|
| Rate for Payer: United Healthcare Commercial |
$16.40
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12.95
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10.36
|
| Rate for Payer: Wellcare Medicare |
$11.66
|
|
|
CREAM GEL EKG
|
Facility
|
OP
|
$4.87
|
|
| Hospital Charge Code |
64901157
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.70 |
| Max. Negotiated Rate |
$3.90 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2.68
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2.44
|
| Rate for Payer: Aetna Government |
$2.44
|
| Rate for Payer: Brighton Health Commercial |
$3.65
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.90
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$3.31
|
| Rate for Payer: Group Health Inc Commercial |
$2.44
|
| Rate for Payer: Group Health Inc Medicare |
$1.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2.44
|
|
|
CREATE EARDRUM OPENING
|
Facility
|
IP
|
$4,086.83
|
|
|
Service Code
|
HCPCS 69436
|
| Hospital Charge Code |
40109051
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,763.60
|
|
|
CREATE EARDRUM OPENING
|
Facility
|
OP
|
$4,086.83
|
|
|
Service Code
|
HCPCS 69436
|
| Hospital Charge Code |
40109051
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,234.52 |
| Max. Negotiated Rate |
$3,065.12 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| 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 |
$3,065.12
|
| 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 |
$1,505.00
|
| 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 |
$2,043.42
|
| 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 Commercial |
$1,409.00
|
| 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
|
|
|
CREATE EARDRUM OPENING LOCAL ANES
|
Facility
|
IP
|
$1,337.85
|
|
|
Service Code
|
HCPCS 69433
|
| Hospital Charge Code |
40109206
|
|
Hospital Revenue Code
|
510
|
| Rate for Payer: Cash Price |
$636.27
|
|
|
CREATE EARDRUM OPENING LOCAL ANES
|
Facility
|
OP
|
$1,337.85
|
|
|
Service Code
|
HCPCS 69433
|
| Hospital Charge Code |
40109206
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$222.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$636.27
|
| Rate for Payer: Aetna Government |
$636.27
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$445.39
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$445.39
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$445.39
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$636.27
|
| Rate for Payer: Cash Price |
$636.27
|
| Rate for Payer: Cash Price |
$636.27
|
| Rate for Payer: Cash Price |
$636.27
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$636.27
|
| 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 |
$636.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$540.83
|
| Rate for Payer: Fidelis Essential Plan QHP |
$566.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$636.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$566.28
|
| 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 |
$668.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$636.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$540.83
|
| Rate for Payer: Healthfirst QHP |
$636.27
|
| Rate for Payer: Humana Medicare |
$649.00
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$636.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$636.27
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$636.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$636.27
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$509.02
|
| Rate for Payer: Wellcare Medicare |
$604.46
|
|
|
CREATINE PHOSPHOKINASE (CPK)
|
Facility
|
OP
|
$16.28
|
|
|
Service Code
|
HCPCS 82550
|
| Hospital Charge Code |
40602410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.56 |
| Max. Negotiated Rate |
$12.21 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6.51
|
| Rate for Payer: Aetna Government |
$6.51
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$4.56
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$4.56
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$4.56
|
| Rate for Payer: Brighton Health Commercial |
$12.21
|
| Rate for Payer: Cash Price |
$6.51
|
| Rate for Payer: Cash Price |
$6.51
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6.51
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$10.35
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$8.76
|
| Rate for Payer: Elderplan Medicare Advantage |
$6.51
|
| Rate for Payer: EmblemHealth Commercial |
$6.51
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5.53
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5.79
|
| Rate for Payer: Fidelis Medicare Advantage |
$6.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5.79
|
| Rate for Payer: Group Health Inc Commercial |
$6.51
|
| Rate for Payer: Group Health Inc Medicare |
$6.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.51
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6.51
|
| Rate for Payer: Healthfirst QHP |
$6.51
|
| Rate for Payer: Humana Medicare |
$6.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6.51
|
| Rate for Payer: United Healthcare Commercial |
$8.25
|
| Rate for Payer: United Healthcare Medicare Advantage |
$6.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6.51
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5.21
|
| Rate for Payer: Wellcare Medicare |
$5.86
|
|
|
CREATINE PHOSPHOKINASE (CPK)
|
Facility
|
IP
|
$16.28
|
|
|
Service Code
|
HCPCS 82550
|
| Hospital Charge Code |
40602410
|
|
Hospital Revenue Code
|
301
|
| Rate for Payer: Cash Price |
$6.51
|
|
|
CREATININE-BF.
|
Facility
|
OP
|
$12.95
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
40602679
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$9.71 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.12
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.18
|
| Rate for Payer: Aetna Government |
$5.18
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.63
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.63
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.63
|
| Rate for Payer: Brighton Health Commercial |
$9.71
|
| Rate for Payer: Cash Price |
$5.18
|
| Rate for Payer: Cash Price |
$5.18
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.18
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.23
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.96
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.18
|
| Rate for Payer: EmblemHealth Commercial |
$5.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.61
|
| Rate for Payer: Group Health Inc Commercial |
$5.18
|
| Rate for Payer: Group Health Inc Medicare |
$5.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.18
|
| Rate for Payer: Healthfirst QHP |
$5.18
|
| Rate for Payer: Humana Medicare |
$5.28
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.18
|
| Rate for Payer: United Healthcare Commercial |
$6.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.18
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.18
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.14
|
| Rate for Payer: Wellcare Medicare |
$4.66
|
|
|
CREATININE-BF.
|
Facility
|
IP
|
$12.95
|
|
|
Service Code
|
HCPCS 82570
|
| Hospital Charge Code |
40602679
|
|
Hospital Revenue Code
|
301
|
| Rate for Payer: Cash Price |
$5.18
|
|
|
CREATININE BLOOD
|
Facility
|
IP
|
$12.80
|
|
|
Service Code
|
HCPCS 82565
|
| Hospital Charge Code |
40602115
|
|
Hospital Revenue Code
|
301
|
| Rate for Payer: Cash Price |
$5.12
|
|
|
CREATININE BLOOD
|
Facility
|
OP
|
$12.80
|
|
|
Service Code
|
HCPCS 82565
|
| Hospital Charge Code |
40602115
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$9.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.04
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.12
|
| Rate for Payer: Aetna Government |
$5.12
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3.58
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3.58
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3.58
|
| Rate for Payer: Brighton Health Commercial |
$9.60
|
| Rate for Payer: Cash Price |
$5.12
|
| Rate for Payer: Cash Price |
$5.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.90
|
| Rate for Payer: Elderplan Medicare Advantage |
$5.12
|
| Rate for Payer: EmblemHealth Commercial |
$5.12
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$5.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.56
|
| Rate for Payer: Group Health Inc Commercial |
$5.12
|
| Rate for Payer: Group Health Inc Medicare |
$5.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5.12
|
| Rate for Payer: Healthfirst QHP |
$5.12
|
| Rate for Payer: Humana Medicare |
$5.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5.12
|
| Rate for Payer: United Healthcare Commercial |
$6.50
|
| Rate for Payer: United Healthcare Medicare Advantage |
$5.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5.12
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.10
|
| Rate for Payer: Wellcare Medicare |
$4.61
|
|
