|
HC PATH CONSULT IN SURG,W ADDN FRZ SEC - BLOCK - FS H&E SLIDE
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
CPT 88332 TC
|
| Hospital Charge Code |
3128833202
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$40.50 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40.50
|
|
|
HC PATH CONSULT IN SURG,W ADDN FRZ SEC - BLOCK - FS H&E SLIDE
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
CPT 88332 TC
|
| Hospital Charge Code |
3128833202
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$11.41 |
| Max. Negotiated Rate |
$60.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$44.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.20
|
| Rate for Payer: Aetna Government |
$12.20
|
| Rate for Payer: Brighton Health Commercial |
$60.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.55
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.41
|
| Rate for Payer: EmblemHealth Commercial |
$29.34
|
| Rate for Payer: Group Health Inc Commercial |
$40.50
|
| Rate for Payer: Group Health Inc Medicare |
$28.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$40.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29.34
|
|
|
HC PATH CONSULT IN SURG,W FRZ SEC - BUNDLED CHARGE
|
Facility
|
IP
|
$434.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
3128833101
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$217.00 |
| Max. Negotiated Rate |
$217.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$217.00
|
|
|
HC PATH CONSULT IN SURG,W FRZ SEC - BUNDLED CHARGE
|
Facility
|
OP
|
$434.00
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
3128833101
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$32.47 |
| Max. Negotiated Rate |
$238.70 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$238.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$209.37
|
| Rate for Payer: Aetna Government |
$209.37
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$146.56
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$146.56
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$146.56
|
| Rate for Payer: Brighton Health Commercial |
$209.37
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$209.37
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$38.57
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$32.47
|
| Rate for Payer: Elderplan Medicare Advantage |
$209.37
|
| Rate for Payer: EmblemHealth Commercial |
$112.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$188.43
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$177.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$186.34
|
| Rate for Payer: Fidelis Medicare Advantage |
$209.37
|
| Rate for Payer: Fidelis Qualified Health Plan |
$186.34
|
| Rate for Payer: Group Health Inc Commercial |
$209.37
|
| Rate for Payer: Group Health Inc Medicare |
$209.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$209.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$209.37
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$112.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$209.37
|
| Rate for Payer: Healthfirst QHP |
$209.37
|
| Rate for Payer: Humana Medicare |
$213.56
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$209.37
|
| Rate for Payer: United Healthcare Medicare Advantage |
$209.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$209.37
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$198.90
|
| Rate for Payer: Wellcare Medicare |
$188.43
|
|
|
HC PATH CONSULT INTRAOP ADDL - LAB PATH CONSULT IN SURG,W ADDN FRZ SEC
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
CPT 88332 TC
|
| Hospital Charge Code |
3128833203
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$40.50 |
| Max. Negotiated Rate |
$40.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40.50
|
|
|
HC PATH CONSULT INTRAOP ADDL - LAB PATH CONSULT IN SURG,W ADDN FRZ SEC
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
CPT 88332 TC
|
| Hospital Charge Code |
3128833203
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$11.41 |
| Max. Negotiated Rate |
$60.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$44.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.20
|
| Rate for Payer: Aetna Government |
$12.20
|
| Rate for Payer: Brighton Health Commercial |
$60.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$13.55
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$11.41
|
| Rate for Payer: EmblemHealth Commercial |
$29.34
|
| Rate for Payer: Group Health Inc Commercial |
$40.50
|
| Rate for Payer: Group Health Inc Medicare |
$28.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$40.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29.34
|
|
|
HC PATIENT EDUCATION, NONPHYSICIAN PROVIDER, INDIVIDUAL, PER SESSION
|
Facility
|
IP
|
$10.00
|
|
|
Service Code
|
CPT S9445
|
| Hospital Charge Code |
942S944501
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$5.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.00
|
|
|
HC PATIENT EDUCATION, NONPHYSICIAN PROVIDER, INDIVIDUAL, PER SESSION
|
Facility
|
OP
|
$10.00
|
|
|
Service Code
|
CPT S9445
|
| Hospital Charge Code |
942S944501
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$33.12
|
| Rate for Payer: Aetna Government |
$33.12
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$146.48
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$146.48
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$65.10
|
| Rate for Payer: Amida Care Medicaid |
$65.10
|
| Rate for Payer: Brighton Health Commercial |
$7.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.80
|
| Rate for Payer: EmblemHealth Commercial |
$250.00
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$146.48
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$65.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$65.10
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$146.48
|
| Rate for Payer: Fidelis Essential Plan QHP |
$146.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$68.36
|
| 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 |
$65.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$65.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$65.10
|
| Rate for Payer: Healthfirst Essential Plan |
$146.48
|
| Rate for Payer: Healthfirst QHP |
$106.11
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$65.10
|
| Rate for Payer: SOMOS Essential |
$146.48
|
| Rate for Payer: United Healthcare Commercial |
$5.00
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$146.48
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$71.61
|
| Rate for Payer: United Healthcare Medicaid |
$65.10
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$65.10
|
|
|
HC PBB PREVENT COUNSEL,INDIV,30 MIN
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 99402
|
| Hospital Charge Code |
5109940201
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$76.50 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$76.50
|
|
|
HC PBB PREVENT COUNSEL,INDIV,30 MIN
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 99402
|
| Hospital Charge Code |
5109940201
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$84.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$37.13
|
| Rate for Payer: Aetna Government |
$37.13
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$161.58
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$161.58
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$71.81
|
| Rate for Payer: Amida Care Medicaid |
$71.81
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Carelon Behavioral Health HARP/QHP |
$71.81
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$217.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$184.48
|
| Rate for Payer: EmblemHealth Commercial |
$250.00
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$161.58
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$71.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$71.81
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$161.58
|
| Rate for Payer: Fidelis Essential Plan QHP |
$161.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$75.40
|
| 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 |
$71.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$71.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$71.81
|
| Rate for Payer: Healthfirst Essential Plan |
$161.58
|
| Rate for Payer: Healthfirst QHP |
$117.05
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$71.81
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$161.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$161.58
|
| Rate for Payer: Optum Medicaid |
$0.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$71.81
|
| Rate for Payer: SOMOS Essential |
$161.58
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$161.58
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$78.99
|
| Rate for Payer: United Healthcare Medicaid |
$71.81
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$71.81
|
|
|
HC PCV13 VACCINE FOR INTRAMUSCULAR USE
|
Facility
|
IP
|
$218.00
|
|
|
Service Code
|
CPT 90670
|
| Hospital Charge Code |
6369067001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$109.00 |
| Max. Negotiated Rate |
$109.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$109.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$109.00
|
|
|
HC PCV13 VACCINE FOR INTRAMUSCULAR USE
|
Facility
|
OP
|
$218.00
|
|
|
Service Code
|
CPT 90670
|
| Hospital Charge Code |
6369067001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$76.30 |
| Max. Negotiated Rate |
$257.99 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$119.90
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$241.38
|
| Rate for Payer: Aetna Government |
$241.38
|
| Rate for Payer: Brighton Health Commercial |
$130.80
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$109.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$125.35
|
| Rate for Payer: EmblemHealth Commercial |
$109.00
|
| Rate for Payer: Group Health Inc Commercial |
$109.00
|
| Rate for Payer: Group Health Inc Medicare |
$76.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$109.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$109.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$257.99
|
| Rate for Payer: United Healthcare Commercial |
$257.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$141.70
|
|
|
HC PCV15 VACCINE FOR INTRAMUSCULAR USE
|
Facility
|
OP
|
$279.00
|
|
|
Service Code
|
CPT 90671
|
| Hospital Charge Code |
6369067101
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$97.65 |
| Max. Negotiated Rate |
$261.15 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$153.45
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$139.50
|
| Rate for Payer: Aetna Government |
$139.50
|
| Rate for Payer: Brighton Health Commercial |
$167.40
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$139.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$160.43
|
| Rate for Payer: EmblemHealth Commercial |
$139.50
|
| Rate for Payer: Group Health Inc Commercial |
$139.50
|
| Rate for Payer: Group Health Inc Medicare |
$97.65
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$139.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$139.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$261.15
|
| Rate for Payer: United Healthcare Commercial |
$246.20
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$181.35
|
|
|
HC PCV15 VACCINE FOR INTRAMUSCULAR USE
|
Facility
|
IP
|
$279.00
|
|
|
Service Code
|
CPT 90671
|
| Hospital Charge Code |
6369067101
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$139.50 |
| Max. Negotiated Rate |
$139.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$139.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$139.50
|
|
|
HC PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Facility
|
IP
|
$802.00
|
|
|
Service Code
|
CPT 90677
|
| Hospital Charge Code |
6369067701
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$401.00 |
| Max. Negotiated Rate |
$401.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$401.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$401.00
|
|
|
HC PCV20 VACCINE FOR INTRAMUSCULAR USE
|
Facility
|
OP
|
$802.00
|
|
|
Service Code
|
CPT 90677
|
| Hospital Charge Code |
6369067701
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$264.74 |
| Max. Negotiated Rate |
$521.30 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$441.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$264.74
|
| Rate for Payer: Aetna Government |
$264.74
|
| Rate for Payer: Brighton Health Commercial |
$481.20
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$401.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$461.15
|
| Rate for Payer: EmblemHealth Commercial |
$401.00
|
| Rate for Payer: Group Health Inc Commercial |
$401.00
|
| Rate for Payer: Group Health Inc Medicare |
$280.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$401.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$401.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$312.90
|
| Rate for Payer: United Healthcare Commercial |
$283.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$521.30
|
|
|
HC PELVIC EXAMINATION
|
Facility
|
OP
|
$148.00
|
|
|
Service Code
|
CPT 99459
|
| Hospital Charge Code |
5109945901
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$24.84 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$81.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$74.00
|
| Rate for Payer: Aetna Government |
$74.00
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$217.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$184.48
|
| Rate for Payer: EmblemHealth Commercial |
$250.00
|
| Rate for Payer: Group Health Inc Commercial |
$250.00
|
| Rate for Payer: Group Health Inc Medicare |
$250.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$74.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$74.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24.84
|
| Rate for Payer: United Healthcare Commercial |
$222.00
|
|
|
HC PELVIC EXAMINATION
|
Facility
|
IP
|
$148.00
|
|
|
Service Code
|
CPT 99459
|
| Hospital Charge Code |
5109945901
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$74.00 |
| Max. Negotiated Rate |
$74.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$74.00
|
|
|
HC PELVIC EXAMINATION W ANESTH
|
Facility
|
IP
|
$8,480.00
|
|
|
Service Code
|
CPT 57410
|
| Hospital Charge Code |
3615741001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,240.00 |
| Max. Negotiated Rate |
$4,240.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,240.00
|
|
|
HC PELVIC EXAMINATION W ANESTH
|
Facility
|
OP
|
$8,480.00
|
|
|
Service Code
|
CPT 57410
|
| Hospital Charge Code |
3615741001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$122.62 |
| Max. Negotiated Rate |
$6,360.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,884.81
|
| Rate for Payer: Aetna Government |
$3,884.81
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,719.37
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,719.37
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,719.37
|
| Rate for Payer: Brighton Health Commercial |
$6,360.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,884.81
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3,092.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,628.64
|
| Rate for Payer: Elderplan Medicare Advantage |
$3,884.81
|
| Rate for Payer: EmblemHealth Commercial |
$3,884.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,496.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,302.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,457.48
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,884.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,457.48
|
| Rate for Payer: Group Health Inc Commercial |
$3,884.81
|
| Rate for Payer: Group Health Inc Medicare |
$3,884.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,884.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,674.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$122.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,302.09
|
| Rate for Payer: Healthfirst QHP |
$3,884.81
|
| Rate for Payer: Humana Medicare |
$3,962.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,884.81
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,884.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,884.81
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,690.57
|
| Rate for Payer: Wellcare Medicare |
$3,690.57
|
|
|
HC PENILE VASCULAR STUDY,LTD OR F/U - US PENIS DOPPLER LIMITED
|
Facility
|
IP
|
$339.00
|
|
|
Service Code
|
CPT 93981
|
| Hospital Charge Code |
4029398101
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$169.50 |
| Max. Negotiated Rate |
$169.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$169.50
|
|
|
HC PENILE VASCULAR STUDY,LTD OR F/U - US PENIS DOPPLER LIMITED
|
Facility
|
OP
|
$339.00
|
|
|
Service Code
|
CPT 93981
|
| Hospital Charge Code |
4029398101
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$72.81 |
| Max. Negotiated Rate |
$271.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$186.45
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$129.93
|
| Rate for Payer: Aetna Government |
$129.93
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$90.95
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$90.95
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$90.95
|
| Rate for Payer: Brighton Health Commercial |
$129.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$129.93
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$271.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$230.52
|
| Rate for Payer: Elderplan Medicare Advantage |
$129.93
|
| Rate for Payer: EmblemHealth Commercial |
$72.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$110.44
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$110.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$115.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$129.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$115.64
|
| Rate for Payer: Group Health Inc Commercial |
$116.94
|
| Rate for Payer: Group Health Inc Medicare |
$116.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$129.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$129.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$80.90
|
| Rate for Payer: Healthfirst Medicare Advantage |
$110.44
|
| Rate for Payer: Healthfirst QHP |
$129.93
|
| Rate for Payer: Humana Medicare |
$132.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$129.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$129.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$129.93
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$123.43
|
| Rate for Payer: Wellcare Medicare |
$123.43
|
|
|
HC PERC RADIOFREQ ABLATE RENAL TUMOR
|
Facility
|
OP
|
$14,640.00
|
|
|
Service Code
|
CPT 50592 TC
|
| Hospital Charge Code |
3615059201
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$439.09 |
| Max. Negotiated Rate |
$10,980.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3,387.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$439.09
|
| Rate for Payer: Aetna Government |
$439.09
|
| Rate for Payer: Brighton Health Commercial |
$10,980.00
|
| 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 |
$7,320.00
|
| Rate for Payer: Group Health Inc Commercial |
$7,320.00
|
| Rate for Payer: Group Health Inc Medicare |
$5,124.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,860.32
|
| Rate for Payer: United Healthcare Commercial |
$2,546.00
|
|
|
HC PERC RADIOFREQ ABLATE RENAL TUMOR
|
Facility
|
IP
|
$14,640.00
|
|
|
Service Code
|
CPT 50592 TC
|
| Hospital Charge Code |
3615059201
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,320.00 |
| Max. Negotiated Rate |
$7,320.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.00
|
|
|
HC PERC SKELETAL FIX, DISTAL RADIUS FRAC
|
Facility
|
OP
|
$8,291.00
|
|
|
Service Code
|
CPT 25606
|
| Hospital Charge Code |
3612560601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$804.76 |
| Max. Negotiated Rate |
$6,218.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,964.33
|
| Rate for Payer: Aetna Government |
$3,964.33
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,775.03
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,775.03
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,775.03
|
| Rate for Payer: Brighton Health Commercial |
$6,218.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,964.33
|
| 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 |
$3,964.33
|
| Rate for Payer: EmblemHealth Commercial |
$3,964.33
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,567.90
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,369.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,528.25
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,964.33
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,528.25
|
| Rate for Payer: Group Health Inc Commercial |
$3,964.33
|
| Rate for Payer: Group Health Inc Medicare |
$3,964.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,964.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,579.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$804.76
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,369.68
|
| Rate for Payer: Healthfirst QHP |
$3,964.33
|
| Rate for Payer: Humana Medicare |
$4,043.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,964.33
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,964.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,964.33
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,766.11
|
| Rate for Payer: Wellcare Medicare |
$3,766.11
|
|
