|
EXPLORATION - BREAST
|
Facility
OP
|
$4,157.25
|
|
|
Service Code
|
HCPCS 19020
|
| Hospital Charge Code |
40010845
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$359.70 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$359.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,078.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$399.67
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
EXPLORATION MAXILLARY SINUS
|
Facility
OP
|
$7,933.18
|
|
|
Service Code
|
HCPCS 31020
|
| Hospital Charge Code |
40109054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$393.30 |
| Max. Negotiated Rate |
$3,966.59 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,723.23
|
| Rate for Payer: Aetna Government |
$3,723.23
|
| Rate for Payer: Cash Price |
$3,723.23
|
| Rate for Payer: Cash Price |
$3,723.23
|
| Rate for Payer: Cash Price |
$3,723.23
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,723.23
|
| 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 |
$3,723.23
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$393.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,164.75
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,313.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,723.23
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,313.67
|
| Rate for Payer: Group Health Inc Commercial |
$3,723.23
|
| Rate for Payer: Group Health Inc Medicare |
$3,723.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,966.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,723.23
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$437.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,164.75
|
| Rate for Payer: Healthfirst QHP |
$3,723.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,723.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,723.23
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,978.58
|
| Rate for Payer: Wellcare Medicare |
$3,537.07
|
|
|
EXPLORATION MEDIASTINUM
|
Facility
OP
|
$1,837.20
|
|
|
Service Code
|
HCPCS 39000
|
| Hospital Charge Code |
40042110
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$513.46 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,010.46
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$513.46
|
| Rate for Payer: Aetna Government |
$513.46
|
| 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: Fidelis CHP/HARP/Medicaid |
$546.11
|
| Rate for Payer: Group Health Inc Commercial |
$918.60
|
| Rate for Payer: Group Health Inc Medicare |
$643.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$918.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$918.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$606.79
|
|
|
EXPLORATION OF ANKLE JOINT
|
Facility
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 27612
|
| Hospital Charge Code |
40019897
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$630.06 |
| Max. Negotiated Rate |
$4,145.52 |
| 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: 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 CHP/HARP/Medicaid |
$630.06
|
| 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 CHP/FHP/Medicaid |
$700.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Senior Whole Health 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
|
|
|
Exploration of penetrating wound (separate procedure); extremity
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 20103
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$388.05 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$388.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$431.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure)
|
Facility
OP
|
$2,915.00
|
|
|
Service Code
|
CPT 49000
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$885.55 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$912.81
|
| Rate for Payer: Aetna Government |
$912.81
|
| 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: Fidelis CHP/HARP/Medicaid |
$885.55
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$983.94
|
|
|
EXPLORATORY LAP-BX OMENTUM
|
Facility
OP
|
$2,365.81
|
|
|
Service Code
|
HCPCS 49255
|
| Hospital Charge Code |
40010870
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$828.03 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,301.20
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$933.33
|
| Rate for Payer: Aetna Government |
$933.33
|
| 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: Fidelis CHP/HARP/Medicaid |
$905.43
|
| Rate for Payer: Group Health Inc Commercial |
$1,182.90
|
| Rate for Payer: Group Health Inc Medicare |
$828.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,182.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,182.90
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,006.03
|
|
|
EXPLORATORY LAP-COLECTOMY
|
Facility
OP
|
$3,992.25
|
|
|
Service Code
|
HCPCS 44140
|
| Hospital Charge Code |
40010890
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,397.29 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,195.74
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,591.50
|
| Rate for Payer: Aetna Government |
$1,591.50
|
| 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: Fidelis CHP/HARP/Medicaid |
$1,543.93
|
| Rate for Payer: Group Health Inc Commercial |
$1,996.12
|
| Rate for Payer: Group Health Inc Medicare |
$1,397.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,996.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,996.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,715.48
|
|
|
EXPLORATORY LAP-COLOSTOMY
|
Facility
OP
|
$3,166.10
|
|
|
Service Code
|
HCPCS 44188
|
| Hospital Charge Code |
40010895
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,108.14 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,741.36
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,448.07
|
| Rate for Payer: Aetna Government |
$1,448.07
|
| 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: Fidelis CHP/HARP/Medicaid |
$1,383.23
|
| Rate for Payer: Group Health Inc Commercial |
$1,583.05
|
| Rate for Payer: Group Health Inc Medicare |
$1,108.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,583.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,583.05
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,536.92
|
|
|
EXPLORATORY LAP - TAH,BSO
|
Facility
OP
|
$2,309.36
|
|
|
Service Code
|
HCPCS 58720
|
| Hospital Charge Code |
40052235
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$808.28 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,270.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$926.32
|
| Rate for Payer: Aetna Government |
$926.32
|
| 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: Fidelis CHP/HARP/Medicaid |
$852.54
|
| Rate for Payer: Group Health Inc Commercial |
$1,154.68
|
| Rate for Payer: Group Health Inc Medicare |
$808.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,154.68
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,154.68
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$947.27
|
|
|
EXPLORE/IRRIGATE TEAR DUCTS
|
Facility
OP
|
$794.85
|
|
|
Service Code
|
HCPCS 68840
|
| Hospital Charge Code |
30305354
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$125.05 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$336.88
|
| Rate for Payer: Aetna Government |
$336.88
|
| Rate for Payer: Brighton Health Commercial |
$233.00
|
| Rate for Payer: Cash Price |
$336.88
|
| Rate for Payer: Cash Price |
$336.88
|
| Rate for Payer: Cash Price |
$336.88
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$336.88
|
| 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 |
$336.88
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$125.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$286.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$299.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$336.88
|
| Rate for Payer: Fidelis Qualified Health Plan |
$299.82
|
| 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 |
$397.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$336.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$138.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$286.35
|
| Rate for Payer: Healthfirst QHP |
$336.88
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$336.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$336.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$336.88
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$269.50
|
| Rate for Payer: Wellcare Medicare |
$320.04
|
|
|
EXPLORE/TREAT KNEE JOINT
|
Facility
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 27331
|
| Hospital Charge Code |
40029695
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$545.93 |
| Max. Negotiated Rate |
$4,145.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,743.15
|
| Rate for Payer: Aetna Government |
$3,743.15
|
| 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 CHP/HARP/Medicaid |
$545.93
|
| 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 CHP/FHP/Medicaid |
$606.59
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Senior Whole Health 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
|
|
|
EXPLORE WOUND ABDOMEN
|
Facility
OP
|
$4,914.88
|
|
|
Service Code
|
HCPCS 20102
|
| Hospital Charge Code |
30106522
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,108.87
|
| Rate for Payer: Aetna Government |
$2,108.87
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$2,108.87
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$2,108.87
|
| Rate for Payer: Cash Price |
$2,108.87
|
| Rate for Payer: Cash Price |
$2,108.87
|
| Rate for Payer: Cash Price |
$2,108.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,108.87
|
| 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 |
$2,108.87
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$291.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,792.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,876.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,108.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,876.89
|
| Rate for Payer: Group Health Inc Commercial |
$525.00
|
| Rate for Payer: Group Health Inc Medicare |
$525.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,457.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,108.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$2,108.87
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,108.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,108.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,108.87
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,687.10
|
| Rate for Payer: Wellcare Medicare |
$2,003.43
|
|
|
EXPLORE WOUND ABDOMEN
|
Facility
OP
|
$4,914.88
|
|
|
Service Code
|
HCPCS 20102
|
| Hospital Charge Code |
40019918
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$291.31 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,108.87
|
| Rate for Payer: Aetna Government |
$2,108.87
|
| Rate for Payer: Cash Price |
$2,108.87
|
| Rate for Payer: Cash Price |
$2,108.87
|
| Rate for Payer: Cash Price |
$2,108.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,108.87
|
| 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 |
$2,108.87
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$291.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,792.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,876.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,108.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,876.89
|
| Rate for Payer: Group Health Inc Commercial |
$2,108.87
|
| Rate for Payer: Group Health Inc Medicare |
$2,108.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,457.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,108.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$323.68
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,792.54
|
| Rate for Payer: Healthfirst QHP |
$2,108.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,108.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,108.87
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,687.10
|
| Rate for Payer: Wellcare Medicare |
$2,003.43
|
|
|
EXPLORE WOUND EXTREMITY
|
Facility
OP
|
$1,847.58
|
|
|
Service Code
|
HCPCS 20103
|
| Hospital Charge Code |
42500131
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$388.05 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,874.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$388.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$923.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$431.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
EXPLORE WOUND EXTREMITY
|
Facility
OP
|
$1,847.58
|
|
|
Service Code
|
HCPCS 20103
|
| Hospital Charge Code |
40064100
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$388.05 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,874.89
|
| Rate for Payer: Aetna Government |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Cash Price |
$1,874.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,874.89
|
| 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 |
$1,874.89
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$388.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,593.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,668.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,874.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,668.65
|
| Rate for Payer: Group Health Inc Commercial |
$1,874.89
|
| Rate for Payer: Group Health Inc Medicare |
$1,874.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$923.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,874.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$431.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,593.66
|
| Rate for Payer: Healthfirst QHP |
$1,874.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,874.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,874.89
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,499.91
|
| Rate for Payer: Wellcare Medicare |
$1,781.15
|
|
|
EXPLOR LAP-CLOSE ABDOMNL WND
|
Facility
OP
|
$2,568.20
|
|
|
Service Code
|
HCPCS 49000
|
| Hospital Charge Code |
40010880
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$885.55 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.51
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$912.81
|
| Rate for Payer: Aetna Government |
$912.81
|
| 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: Fidelis CHP/HARP/Medicaid |
$885.55
|
| Rate for Payer: Group Health Inc Commercial |
$1,284.10
|
| Rate for Payer: Group Health Inc Medicare |
$898.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,284.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,284.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$983.94
|
|
|
EXPLOR LAP-CLOSE PERF ULCER
|
Facility
OP
|
$4,583.88
|
|
|
Service Code
|
HCPCS 43840
|
| Hospital Charge Code |
40010885
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,316.45 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,521.13
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,316.45
|
| Rate for Payer: Aetna Government |
$1,316.45
|
| 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: Fidelis CHP/HARP/Medicaid |
$1,576.47
|
| Rate for Payer: Group Health Inc Commercial |
$2,291.94
|
| Rate for Payer: Group Health Inc Medicare |
$1,604.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,291.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,291.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,751.63
|
|
|
EXPLOR LAP-INSERT GAST. TUBE
|
Facility
OP
|
$4,716.98
|
|
|
Service Code
|
HCPCS 43830
|
| Hospital Charge Code |
40010905
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$815.08 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,200.46
|
| Rate for Payer: Aetna Government |
$2,200.46
|
| Rate for Payer: Cash Price |
$2,200.46
|
| Rate for Payer: Cash Price |
$2,200.46
|
| Rate for Payer: Cash Price |
$2,200.46
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,200.46
|
| 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: Elderplan Medicare Advantage |
$2,200.46
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$815.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,870.39
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,958.41
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,200.46
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,958.41
|
| Rate for Payer: Group Health Inc Commercial |
$2,200.46
|
| Rate for Payer: Group Health Inc Medicare |
$2,200.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,358.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,200.46
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$905.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,870.39
|
| Rate for Payer: Healthfirst QHP |
$2,200.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,200.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,200.46
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,760.37
|
| Rate for Payer: Wellcare Medicare |
$2,090.44
|
|
|
EXPLOR LAP-LIGATION BLEEDER
|
Facility
OP
|
$4,537.05
|
|
|
Service Code
|
HCPCS 43501
|
| Hospital Charge Code |
40010910
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,505.00 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,495.38
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,598.00
|
| Rate for Payer: Aetna Government |
$1,598.00
|
| 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: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,563.44
|
| Rate for Payer: Group Health Inc Commercial |
$2,268.52
|
| Rate for Payer: Group Health Inc Medicare |
$1,587.97
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,268.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,268.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,737.16
|
|
|
EXPLOR LAP-LYSIS OF ADHESNS
|
Facility
OP
|
$3,669.80
|
|
|
Service Code
|
HCPCS 44005
|
| Hospital Charge Code |
40010915
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,260.26 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,018.39
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,298.66
|
| Rate for Payer: Aetna Government |
$1,298.66
|
| 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: Fidelis CHP/HARP/Medicaid |
$1,260.26
|
| Rate for Payer: Group Health Inc Commercial |
$1,834.90
|
| Rate for Payer: Group Health Inc Medicare |
$1,284.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,834.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,834.90
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,400.29
|
|
|
EXPLOR LAP-REPR LESION, COLON
|
Facility
OP
|
$3,532.08
|
|
|
Service Code
|
HCPCS 44604
|
| Hospital Charge Code |
40010920
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,212.57 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,942.64
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,253.85
|
| Rate for Payer: Aetna Government |
$1,253.85
|
| 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: Fidelis CHP/HARP/Medicaid |
$1,212.57
|
| Rate for Payer: Group Health Inc Commercial |
$1,766.04
|
| Rate for Payer: Group Health Inc Medicare |
$1,236.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,766.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,766.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,347.30
|
|
|
EXPLOR LAP - SALPINGECTOMY
|
Facility
OP
|
$14,640.10
|
|
|
Service Code
|
HCPCS 58661
|
| Hospital Charge Code |
40052230
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$732.47 |
| Max. Negotiated Rate |
$7,320.05 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,880.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6,672.53
|
| Rate for Payer: Aetna Government |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Cash Price |
$6,672.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$6,672.53
|
| 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 |
$6,672.53
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$732.47
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,671.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,938.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$6,672.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,938.55
|
| Rate for Payer: Group Health Inc Commercial |
$6,672.53
|
| Rate for Payer: Group Health Inc Medicare |
$6,672.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,320.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6,672.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$813.86
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,671.65
|
| Rate for Payer: Healthfirst QHP |
$6,672.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$6,672.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$6,672.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$5,338.02
|
| Rate for Payer: Wellcare Medicare |
$6,338.90
|
|
|
EXPLOR LAP-VGTMY, PYLORPLSTY
|
Facility
OP
|
$3,239.70
|
|
|
Service Code
|
HCPCS 43640
|
| Hospital Charge Code |
40010925
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,133.90 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,781.84
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,401.25
|
| Rate for Payer: Aetna Government |
$1,401.25
|
| 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: Fidelis CHP/HARP/Medicaid |
$1,387.58
|
| Rate for Payer: Group Health Inc Commercial |
$1,619.85
|
| Rate for Payer: Group Health Inc Medicare |
$1,133.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,619.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,619.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,541.75
|
|
|
EXPLOR-SCROTAL EPIDIDYMITIS
|
Facility
OP
|
$9,142.40
|
|
|
Service Code
|
HCPCS 55110
|
| Hospital Charge Code |
40122995
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$422.09 |
| Max. Negotiated Rate |
$4,571.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,031.47
|
| Rate for Payer: Aetna Government |
$4,031.47
|
| Rate for Payer: Cash Price |
$4,031.47
|
| Rate for Payer: Cash Price |
$4,031.47
|
| Rate for Payer: Cash Price |
$4,031.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,031.47
|
| 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 |
$4,031.47
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$422.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,426.75
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,588.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,031.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,588.01
|
| Rate for Payer: Group Health Inc Commercial |
$4,031.47
|
| Rate for Payer: Group Health Inc Medicare |
$4,031.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,571.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,031.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$468.99
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,426.75
|
| Rate for Payer: Healthfirst QHP |
$4,031.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,031.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,031.47
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,225.18
|
| Rate for Payer: Wellcare Medicare |
$3,829.90
|
|
