|
HC TISSUE CULTURE FOR NEOPLASTIC DISORDERS; BONE MARROW, BLOOD CELLS
|
Facility
|
OP
|
$313.00
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
3118823701
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$100.62 |
| Max. Negotiated Rate |
$227.32 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$172.15
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$143.75
|
| Rate for Payer: Aetna Government |
$143.75
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$100.62
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$100.62
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$100.62
|
| Rate for Payer: Brighton Health Commercial |
$143.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$143.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$214.67
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$180.69
|
| Rate for Payer: Elderplan Medicare Advantage |
$143.75
|
| Rate for Payer: EmblemHealth Commercial |
$143.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$129.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$122.19
|
| Rate for Payer: Fidelis Essential Plan QHP |
$127.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$143.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$127.94
|
| Rate for Payer: Group Health Inc Commercial |
$143.75
|
| Rate for Payer: Group Health Inc Medicare |
$143.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$143.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$143.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$101.03
|
| Rate for Payer: Healthfirst Essential Plan |
$227.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$143.75
|
| Rate for Payer: Healthfirst QHP |
$143.75
|
| Rate for Payer: Humana Medicare |
$146.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$143.75
|
| Rate for Payer: United Healthcare Medicare Advantage |
$143.75
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$143.75
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$101.03
|
| Rate for Payer: Wellcare Medicare |
$129.38
|
|
|
HC TISSUE CULTURE FOR NEOPLASTIC DISORDERS; BONE MARROW, BLOOD CELLS
|
Facility
|
IP
|
$313.00
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
3118823701
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$156.50 |
| Max. Negotiated Rate |
$156.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$156.50
|
|
|
HC TISSUE CULTURE, LYMPHOCYTE - CHROMOSOME ANALYSIS
|
Facility
|
OP
|
$291.00
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
3108823001
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$40.40 |
| Max. Negotiated Rate |
$197.99 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$160.05
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$116.49
|
| Rate for Payer: Aetna Government |
$116.49
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$81.54
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$81.54
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$81.54
|
| Rate for Payer: Brighton Health Commercial |
$116.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$116.49
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$197.99
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$166.65
|
| Rate for Payer: Elderplan Medicare Advantage |
$116.49
|
| Rate for Payer: EmblemHealth Commercial |
$116.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$104.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$99.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$103.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$116.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$103.68
|
| Rate for Payer: Group Health Inc Commercial |
$116.49
|
| Rate for Payer: Group Health Inc Medicare |
$116.49
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$116.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$116.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$40.40
|
| Rate for Payer: Healthfirst Essential Plan |
$90.90
|
| Rate for Payer: Healthfirst Medicare Advantage |
$116.49
|
| Rate for Payer: Healthfirst QHP |
$116.49
|
| Rate for Payer: Humana Medicare |
$118.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$116.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$116.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$116.49
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$40.40
|
| Rate for Payer: Wellcare Medicare |
$104.84
|
|
|
HC TISSUE CULTURE, LYMPHOCYTE - CHROMOSOME ANALYSIS
|
Facility
|
IP
|
$291.00
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
3108823001
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$145.50 |
| Max. Negotiated Rate |
$145.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$145.50
|
|
|
HC TISSUE CULTURE, LYMPHOCYTE - CMT1A DNA PROBE
|
Facility
|
OP
|
$291.00
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
3108823002
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$40.40 |
| Max. Negotiated Rate |
$197.99 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$160.05
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$116.49
|
| Rate for Payer: Aetna Government |
$116.49
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$81.54
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$81.54
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$81.54
|
| Rate for Payer: Brighton Health Commercial |
$116.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$116.49
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$197.99
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$166.65
|
| Rate for Payer: Elderplan Medicare Advantage |
$116.49
|
| Rate for Payer: EmblemHealth Commercial |
$116.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$104.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$99.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$103.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$116.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$103.68
|
| Rate for Payer: Group Health Inc Commercial |
$116.49
|
| Rate for Payer: Group Health Inc Medicare |
$116.49
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$116.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$116.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$40.40
|
| Rate for Payer: Healthfirst Essential Plan |
$90.90
|
| Rate for Payer: Healthfirst Medicare Advantage |
$116.49
|
| Rate for Payer: Healthfirst QHP |
$116.49
|
| Rate for Payer: Humana Medicare |
$118.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$116.49
|
| Rate for Payer: United Healthcare Medicare Advantage |
$116.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$116.49
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$40.40
|
| Rate for Payer: Wellcare Medicare |
$104.84
|
|
|
HC TISSUE CULTURE, LYMPHOCYTE - CMT1A DNA PROBE
|
Facility
|
IP
|
$291.00
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
3108823002
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$145.50 |
| Max. Negotiated Rate |
$145.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$145.50
|
|
|
HC TISSUE EXAM BY KOH - KOH PREP
|
Facility
|
IP
|
$10.00
|
|
|
Service Code
|
CPT 87220
|
| Hospital Charge Code |
3068722001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.00 |
| Max. Negotiated Rate |
$5.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.00
|
|
|
HC TISSUE EXAM BY KOH - KOH PREP
|
Facility
|
OP
|
$10.00
|
|
|
Service Code
|
CPT 87220
|
| Hospital Charge Code |
3068722001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$7.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4.27
|
| Rate for Payer: Aetna Government |
$4.27
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2.99
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2.99
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2.99
|
| Rate for Payer: Brighton Health Commercial |
$7.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4.27
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$7.26
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$6.11
|
| Rate for Payer: Elderplan Medicare Advantage |
$4.27
|
| Rate for Payer: EmblemHealth Commercial |
$4.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.63
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$4.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3.80
|
| Rate for Payer: Group Health Inc Commercial |
$4.27
|
| Rate for Payer: Group Health Inc Medicare |
$4.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$4.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$4.27
|
| Rate for Payer: Healthfirst QHP |
$4.27
|
| Rate for Payer: Humana Medicare |
$4.36
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4.27
|
| Rate for Payer: United Healthcare Commercial |
$5.41
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.27
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$4.06
|
| Rate for Payer: Wellcare Medicare |
$3.84
|
|
|
HC TISSUE MATRIX 20X20
|
Facility
|
OP
|
$21,546.00
|
|
|
Service Code
|
CPT Q4100
|
| Hospital Charge Code |
636Q410007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.74 |
| Max. Negotiated Rate |
$14,004.90 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$11,850.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.74
|
| Rate for Payer: Aetna Government |
$9.74
|
| Rate for Payer: Brighton Health Commercial |
$12,927.60
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$10,773.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12,388.95
|
| Rate for Payer: EmblemHealth Commercial |
$10,773.00
|
| Rate for Payer: Group Health Inc Commercial |
$10,773.00
|
| Rate for Payer: Group Health Inc Medicare |
$7,541.10
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10,773.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10,773.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$14,004.90
|
|
|
HC TISSUE MATRIX 20X20
|
Facility
|
IP
|
$21,546.00
|
|
|
Service Code
|
CPT Q4100
|
| Hospital Charge Code |
636Q410007
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10,773.00 |
| Max. Negotiated Rate |
$10,773.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10,773.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10,773.00
|
|
|
HC TISSUE TRANSGLUTAMINASE, EACH IMMUNOGLOBULIN (IG) CLASS
|
Facility
|
IP
|
$117.00
|
|
|
Service Code
|
CPT 86364
|
| Hospital Charge Code |
3028636401
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$58.50
|
|
|
HC TISSUE TRANSGLUTAMINASE, EACH IMMUNOGLOBULIN (IG) CLASS
|
Facility
|
OP
|
$117.00
|
|
|
Service Code
|
CPT 86364
|
| Hospital Charge Code |
3028636401
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.98 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$64.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$11.53
|
| Rate for Payer: Aetna Government |
$11.53
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8.07
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8.07
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8.07
|
| Rate for Payer: Brighton Health Commercial |
$87.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$11.53
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$93.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$79.56
|
| Rate for Payer: Elderplan Medicare Advantage |
$11.53
|
| Rate for Payer: EmblemHealth Commercial |
$11.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$10.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.80
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$11.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.26
|
| Rate for Payer: Group Health Inc Commercial |
$11.53
|
| Rate for Payer: Group Health Inc Medicare |
$11.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$11.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$11.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$6.98
|
| Rate for Payer: Healthfirst Essential Plan |
$15.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11.53
|
| Rate for Payer: Healthfirst QHP |
$11.53
|
| Rate for Payer: Humana Medicare |
$11.76
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$11.53
|
| Rate for Payer: United Healthcare Commercial |
$10.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$11.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$11.53
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6.98
|
| Rate for Payer: Wellcare Medicare |
$10.38
|
|
|
HC TOBACCO USE CESSATION INTENSIVE >10 MINUTES
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 99407
|
| Hospital Charge Code |
9409940701
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$25.48 |
| Max. Negotiated Rate |
$65.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$45.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$36.40
|
| Rate for Payer: Aetna Government |
$36.40
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$25.48
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$25.48
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$25.48
|
| Rate for Payer: Brighton Health Commercial |
$61.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$36.40
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$65.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$55.76
|
| Rate for Payer: Elderplan Medicare Advantage |
$36.40
|
| Rate for Payer: EmblemHealth Commercial |
$36.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$32.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$30.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$32.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$36.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$32.40
|
| Rate for Payer: Group Health Inc Commercial |
$36.40
|
| Rate for Payer: Group Health Inc Medicare |
$36.40
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$36.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$36.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$27.46
|
| Rate for Payer: Healthfirst Medicare Advantage |
$30.94
|
| Rate for Payer: Healthfirst QHP |
$36.40
|
| Rate for Payer: Humana Medicare |
$37.13
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$38.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$36.40
|
| Rate for Payer: United Healthcare Commercial |
$41.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$36.40
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$34.58
|
| Rate for Payer: Wellcare Medicare |
$34.58
|
|
|
HC TOBACCO USE CESSATION INTENSIVE >10 MINUTES
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT 99407
|
| Hospital Charge Code |
9409940701
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$41.00 |
| Max. Negotiated Rate |
$41.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$41.00
|
|
|
HC TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 99406
|
| Hospital Charge Code |
9409940601
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$13.00 |
| Max. Negotiated Rate |
$65.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$45.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$36.40
|
| Rate for Payer: Aetna Government |
$36.40
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$25.48
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$25.48
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$25.48
|
| Rate for Payer: Brighton Health Commercial |
$61.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$36.40
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$65.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$55.76
|
| Rate for Payer: Elderplan Medicare Advantage |
$36.40
|
| Rate for Payer: EmblemHealth Commercial |
$36.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$32.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$30.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$32.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$36.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$32.40
|
| Rate for Payer: Group Health Inc Commercial |
$36.40
|
| Rate for Payer: Group Health Inc Medicare |
$36.40
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$36.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$36.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$13.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$30.94
|
| Rate for Payer: Healthfirst QHP |
$36.40
|
| Rate for Payer: Humana Medicare |
$37.13
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$38.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$36.40
|
| Rate for Payer: United Healthcare Commercial |
$41.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$36.40
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$34.58
|
| Rate for Payer: Wellcare Medicare |
$34.58
|
|
|
HC TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT 99406
|
| Hospital Charge Code |
9409940601
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$41.00 |
| Max. Negotiated Rate |
$41.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$41.00
|
|
|
HC TONE DECAY
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
CPT 92563
|
| Hospital Charge Code |
4719256301
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$33.57 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$55.55
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$47.96
|
| Rate for Payer: Aetna Government |
$47.96
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$33.57
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$33.57
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$33.57
|
| Rate for Payer: Brighton Health Commercial |
$75.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$47.96
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$80.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$68.68
|
| Rate for Payer: Elderplan Medicare Advantage |
$47.96
|
| Rate for Payer: EmblemHealth Commercial |
$47.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$43.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$40.77
|
| Rate for Payer: Fidelis Essential Plan QHP |
$42.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$47.96
|
| Rate for Payer: Fidelis Qualified Health Plan |
$42.68
|
| Rate for Payer: Group Health Inc Commercial |
$47.96
|
| Rate for Payer: Group Health Inc Medicare |
$47.96
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$47.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$47.96
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$41.76
|
| Rate for Payer: Healthfirst Medicare Advantage |
$40.77
|
| Rate for Payer: Healthfirst QHP |
$47.96
|
| Rate for Payer: Humana Medicare |
$48.92
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$47.96
|
| Rate for Payer: United Healthcare Commercial |
$158.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$47.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$47.96
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$45.56
|
| Rate for Payer: Wellcare Medicare |
$45.56
|
|
|
HC TONE DECAY
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
CPT 92563
|
| Hospital Charge Code |
4719256301
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$50.50 |
| Max. Negotiated Rate |
$50.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$50.50
|
|
|
HC TONGUE BASE SUSPENSE, PERM SUTURE
|
Facility
|
OP
|
$14,691.00
|
|
|
Service Code
|
CPT 41512
|
| Hospital Charge Code |
4504151201
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$7,589.26 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$780.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$7,227.87
|
| Rate for Payer: Aetna Government |
$7,227.87
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$5,059.51
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$5,059.51
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$5,059.51
|
| Rate for Payer: Brighton Health Commercial |
$874.00
|
| Rate for Payer: Carelon Behavioral Health CHP/Medicaid |
$7,227.87
|
| Rate for Payer: Carelon Behavioral Health Medicare Advantage |
$7,227.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$7,227.87
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$792.81
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$673.89
|
| Rate for Payer: Elderplan Medicare Advantage |
$7,227.87
|
| Rate for Payer: EmblemHealth Commercial |
$525.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$6,505.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$6,143.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$6,432.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$7,227.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$6,432.80
|
| 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 |
$7,227.87
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,697.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$165.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$225.00
|
| Rate for Payer: Healthfirst QHP |
$7,227.87
|
| Rate for Payer: Humana Medicare |
$7,372.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$7,589.26
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$7,227.87
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$7,227.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7,227.87
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$6,866.48
|
| Rate for Payer: Wellcare Medicare |
$6,866.48
|
|
|
HC TONGUE BASE SUSPENSE, PERM SUTURE
|
Facility
|
IP
|
$14,691.00
|
|
|
Service Code
|
CPT 41512
|
| Hospital Charge Code |
4504151201
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$7,345.50 |
| Max. Negotiated Rate |
$7,345.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7,345.50
|
|
|
HC TOPICAL FLUORIDE VARNISH
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT D1206
|
| Hospital Charge Code |
361D120601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$37.50 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$37.50
|
|
|
HC TOPICAL FLUORIDE VARNISH
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT D1206
|
| Hospital Charge Code |
361D120601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$16.51 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$41.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16.51
|
| Rate for Payer: Aetna Government |
$16.51
|
| Rate for Payer: Brighton Health Commercial |
$56.25
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$60.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$51.00
|
| Rate for Payer: EmblemHealth Commercial |
$37.50
|
| Rate for Payer: Group Health Inc Commercial |
$37.50
|
| Rate for Payer: Group Health Inc Medicare |
$26.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$37.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$37.50
|
|
|
HC TOTAL ABDOM HYSTERECTOMY
|
Facility
|
OP
|
$8,480.00
|
|
|
Service Code
|
CPT 58150
|
| Hospital Charge Code |
3615815001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,182.75 |
| Max. Negotiated Rate |
$6,360.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$4,664.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,267.60
|
| Rate for Payer: Aetna Government |
$1,267.60
|
| Rate for Payer: Brighton Health Commercial |
$6,360.00
|
| 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 |
$4,240.00
|
| Rate for Payer: Group Health Inc Commercial |
$4,240.00
|
| Rate for Payer: Group Health Inc Medicare |
$2,968.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,240.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,240.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,182.75
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
|
|
HC TOTAL ABDOM HYSTERECTOMY
|
Facility
|
IP
|
$8,480.00
|
|
|
Service Code
|
CPT 58150
|
| Hospital Charge Code |
3615815001
|
|
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 TOTAL CORTISOL - ACTH STIMULATION 1 HOUR
|
Facility
|
OP
|
$40.00
|
|
|
Service Code
|
CPT 82533
|
| Hospital Charge Code |
3018253304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.41 |
| Max. Negotiated Rate |
$36.67 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$22.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16.30
|
| Rate for Payer: Aetna Government |
$16.30
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$11.41
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$11.41
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$11.41
|
| Rate for Payer: Brighton Health Commercial |
$30.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$16.30
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$27.72
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$23.33
|
| Rate for Payer: Elderplan Medicare Advantage |
$16.30
|
| Rate for Payer: EmblemHealth Commercial |
$16.30
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$14.67
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$13.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$14.51
|
| Rate for Payer: Fidelis Medicare Advantage |
$16.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$14.51
|
| Rate for Payer: Group Health Inc Commercial |
$16.30
|
| Rate for Payer: Group Health Inc Medicare |
$16.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.30
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.30
|
| Rate for Payer: Healthfirst Essential Plan |
$36.67
|
| Rate for Payer: Healthfirst Medicare Advantage |
$16.30
|
| Rate for Payer: Healthfirst QHP |
$16.30
|
| Rate for Payer: Humana Medicare |
$16.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$16.30
|
| Rate for Payer: United Healthcare Commercial |
$20.66
|
| Rate for Payer: United Healthcare Medicare Advantage |
$16.30
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16.30
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$16.30
|
| Rate for Payer: Wellcare Medicare |
$14.67
|
|
