|
HC ZZ TECH. TIME ADD'L HALF HOUR
|
Facility
|
IP
|
$285.00
|
|
| Hospital Charge Code |
3600000007
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$142.50 |
| Max. Negotiated Rate |
$142.50 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$142.50
|
|
|
HC ZZ TECH. TIME ADD'L QR. HOUR
|
Facility
|
IP
|
$142.00
|
|
| Hospital Charge Code |
3600000008
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$71.00 |
| Max. Negotiated Rate |
$71.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$71.00
|
|
|
HC ZZ TECH. TIME ADD'L QR. HOUR
|
Facility
|
OP
|
$142.00
|
|
| Hospital Charge Code |
3600000008
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$49.70 |
| Max. Negotiated Rate |
$113.60 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$78.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$71.00
|
| Rate for Payer: Aetna Government |
$71.00
|
| Rate for Payer: Brighton Health Commercial |
$106.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$113.60
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$96.56
|
| Rate for Payer: EmblemHealth Commercial |
$71.00
|
| Rate for Payer: Group Health Inc Commercial |
$71.00
|
| Rate for Payer: Group Health Inc Medicare |
$49.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$71.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$71.00
|
|
|
HEADACHES OTHER THAN MIGRAINE
|
Facility
|
OP
|
$247.52
|
|
|
Service Code
|
EAPG 00530
|
| Min. Negotiated Rate |
$180.52 |
| Max. Negotiated Rate |
$247.52 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$180.52
|
| Rate for Payer: Healthfirst Commercial |
$247.52
|
|
|
HEAD TRAUMA
|
Facility
|
OP
|
$236.71
|
|
|
Service Code
|
EAPG 00532
|
| Min. Negotiated Rate |
$171.26 |
| Max. Negotiated Rate |
$236.71 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$171.26
|
| Rate for Payer: Healthfirst Commercial |
$236.71
|
|
|
Head trauma w coma >1 hr or hemorrhage
|
Facility
|
IP
|
$47,449.67
|
|
|
Service Code
|
APR-DRG 0552
|
| Min. Negotiated Rate |
$9,980.00 |
| Max. Negotiated Rate |
$47,449.67 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$47,449.67
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$47,449.67
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$21,088.74
|
| Rate for Payer: Amida Care Medicaid |
$21,088.74
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$47,449.67
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$21,088.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21,088.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$25,306.49
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21,088.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$21,088.74
|
| Rate for Payer: Healthfirst Commercial |
$15,978.00
|
| Rate for Payer: Healthfirst Essential Plan |
$47,449.67
|
| Rate for Payer: Healthfirst QHP |
$9,980.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$21,088.74
|
| Rate for Payer: SOMOS Essential |
$47,449.67
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$47,449.67
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$47,449.67
|
| Rate for Payer: United Healthcare Medicaid |
$21,088.74
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$21,088.74
|
|
|
Head trauma w coma >1 hr or hemorrhage
|
Facility
|
IP
|
$58,411.93
|
|
|
Service Code
|
APR-DRG 0553
|
| Min. Negotiated Rate |
$17,160.00 |
| Max. Negotiated Rate |
$58,411.93 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$58,411.93
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$58,411.93
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$25,960.86
|
| Rate for Payer: Amida Care Medicaid |
$25,960.86
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$58,411.93
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$25,960.86
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$25,960.86
|
| Rate for Payer: Fidelis Qualified Health Plan |
$31,153.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25,960.86
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25,960.86
|
| Rate for Payer: Healthfirst Commercial |
$27,084.00
|
| Rate for Payer: Healthfirst Essential Plan |
$58,411.93
|
| Rate for Payer: Healthfirst QHP |
$17,160.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$25,960.86
|
| Rate for Payer: SOMOS Essential |
$58,411.93
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$58,411.93
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$58,411.93
|
| Rate for Payer: United Healthcare Medicaid |
$25,960.86
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$25,960.86
|
|
|
Head trauma w coma >1 hr or hemorrhage
|
Facility
|
IP
|
$91,518.57
|
|
|
Service Code
|
APR-DRG 0554
|
| Min. Negotiated Rate |
$34,326.00 |
| Max. Negotiated Rate |
$91,518.57 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$91,518.57
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$91,518.57
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$40,674.92
|
| Rate for Payer: Amida Care Medicaid |
$40,674.92
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$91,518.57
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$40,674.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$40,674.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$48,809.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40,674.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$40,674.92
|
| Rate for Payer: Healthfirst Commercial |
$59,454.00
|
| Rate for Payer: Healthfirst Essential Plan |
$91,518.57
|
| Rate for Payer: Healthfirst QHP |
$34,326.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$40,674.92
|
| Rate for Payer: SOMOS Essential |
$91,518.57
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$91,518.57
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$91,518.57
|
| Rate for Payer: United Healthcare Medicaid |
$40,674.92
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$40,674.92
|
|
|
Head trauma w coma >1 hr or hemorrhage
|
Facility
|
IP
|
$41,811.12
|
|
|
Service Code
|
APR-DRG 0551
|
| Min. Negotiated Rate |
$6,822.00 |
| Max. Negotiated Rate |
$41,811.12 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$41,811.12
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$41,811.12
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18,582.72
|
| Rate for Payer: Amida Care Medicaid |
$18,582.72
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$41,811.12
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$18,582.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,582.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22,299.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,582.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,582.72
|
| Rate for Payer: Healthfirst Commercial |
$11,046.00
|
| Rate for Payer: Healthfirst Essential Plan |
$41,811.12
|
| Rate for Payer: Healthfirst QHP |
$6,822.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,582.72
|
| Rate for Payer: SOMOS Essential |
$41,811.12
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$41,811.12
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$41,811.12
|
| Rate for Payer: United Healthcare Medicaid |
$18,582.72
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,582.72
|
|
|
HEAD TRAUMA WITH LOC/COMA MORE THEN 1 HR
|
Facility
|
OP
|
$171.26
|
|
|
Service Code
|
EAPG 00538
|
| Min. Negotiated Rate |
$171.26 |
| Max. Negotiated Rate |
$171.26 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$171.26
|
|
|
Heart failure
|
Facility
|
IP
|
$82,816.29
|
|
|
Service Code
|
APR-DRG 1944
|
| Min. Negotiated Rate |
$28,654.00 |
| Max. Negotiated Rate |
$82,816.29 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$82,816.29
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$82,816.29
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$36,807.24
|
| Rate for Payer: Amida Care Medicaid |
$36,807.24
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$82,816.29
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$36,807.24
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36,807.24
|
| Rate for Payer: Fidelis Qualified Health Plan |
$44,168.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$36,807.24
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$36,807.24
|
| Rate for Payer: Healthfirst Commercial |
$47,507.00
|
| Rate for Payer: Healthfirst Essential Plan |
$82,816.29
|
| Rate for Payer: Healthfirst QHP |
$28,654.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$36,807.24
|
| Rate for Payer: SOMOS Essential |
$82,816.29
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$82,816.29
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$82,816.29
|
| Rate for Payer: United Healthcare Medicaid |
$36,807.24
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$36,807.24
|
|
|
Heart failure
|
Facility
|
IP
|
$42,038.01
|
|
|
Service Code
|
APR-DRG 1941
|
| Min. Negotiated Rate |
$6,668.00 |
| Max. Negotiated Rate |
$42,038.01 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$42,038.01
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$42,038.01
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$18,683.56
|
| Rate for Payer: Amida Care Medicaid |
$18,683.56
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$42,038.01
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$18,683.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18,683.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22,420.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18,683.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18,683.56
|
| Rate for Payer: Healthfirst Commercial |
$11,296.00
|
| Rate for Payer: Healthfirst Essential Plan |
$42,038.01
|
| Rate for Payer: Healthfirst QHP |
$6,668.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18,683.56
|
| Rate for Payer: SOMOS Essential |
$42,038.01
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$42,038.01
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$42,038.01
|
| Rate for Payer: United Healthcare Medicaid |
$18,683.56
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$18,683.56
|
|
|
Heart failure
|
Facility
|
IP
|
$54,769.57
|
|
|
Service Code
|
APR-DRG 1943
|
| Min. Negotiated Rate |
$13,142.00 |
| Max. Negotiated Rate |
$54,769.57 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$54,769.57
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$54,769.57
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$24,342.03
|
| Rate for Payer: Amida Care Medicaid |
$24,342.03
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$54,769.57
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$24,342.03
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$24,342.03
|
| Rate for Payer: Fidelis Qualified Health Plan |
$29,210.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$24,342.03
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24,342.03
|
| Rate for Payer: Healthfirst Commercial |
$22,769.00
|
| Rate for Payer: Healthfirst Essential Plan |
$54,769.57
|
| Rate for Payer: Healthfirst QHP |
$13,142.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24,342.03
|
| Rate for Payer: SOMOS Essential |
$54,769.57
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$54,769.57
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$54,769.57
|
| Rate for Payer: United Healthcare Medicaid |
$24,342.03
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$24,342.03
|
|
|
Heart failure
|
Facility
|
IP
|
$45,931.86
|
|
|
Service Code
|
APR-DRG 1942
|
| Min. Negotiated Rate |
$8,532.00 |
| Max. Negotiated Rate |
$45,931.86 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$45,931.86
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$45,931.86
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$20,414.16
|
| Rate for Payer: Amida Care Medicaid |
$20,414.16
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$45,931.86
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$20,414.16
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20,414.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24,496.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$20,414.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20,414.16
|
| Rate for Payer: Healthfirst Commercial |
$14,579.00
|
| Rate for Payer: Healthfirst Essential Plan |
$45,931.86
|
| Rate for Payer: Healthfirst QHP |
$8,532.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$20,414.16
|
| Rate for Payer: SOMOS Essential |
$45,931.86
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$45,931.86
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$45,931.86
|
| Rate for Payer: United Healthcare Medicaid |
$20,414.16
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$20,414.16
|
|
|
HEART FAILURE
|
Facility
|
OP
|
$240.47
|
|
|
Service Code
|
EAPG 00594
|
| Min. Negotiated Rate |
$173.57 |
| Max. Negotiated Rate |
$240.47 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$173.57
|
| Rate for Payer: Healthfirst Commercial |
$240.47
|
|
|
Heart &/or lung transplant
|
Facility
|
IP
|
$696,293.00
|
|
|
Service Code
|
APR-DRG 0024
|
| Min. Negotiated Rate |
$286,979.13 |
| Max. Negotiated Rate |
$696,293.00 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$645,703.04
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$645,703.04
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$286,979.13
|
| Rate for Payer: Amida Care Medicaid |
$286,979.13
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$645,703.04
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$286,979.13
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$286,979.13
|
| Rate for Payer: Fidelis Qualified Health Plan |
$344,374.96
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$286,979.13
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$286,979.13
|
| Rate for Payer: Healthfirst Commercial |
$696,293.00
|
| Rate for Payer: Healthfirst Essential Plan |
$645,703.04
|
| Rate for Payer: Healthfirst QHP |
$440,499.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$286,979.13
|
| Rate for Payer: SOMOS Essential |
$645,703.04
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$645,703.04
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$645,703.04
|
| Rate for Payer: United Healthcare Medicaid |
$286,979.13
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$286,979.13
|
|
|
Heart &/or lung transplant
|
Facility
|
IP
|
$263,266.00
|
|
|
Service Code
|
APR-DRG 0022
|
| Min. Negotiated Rate |
$114,640.75 |
| Max. Negotiated Rate |
$263,266.00 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$257,941.69
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$257,941.69
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$114,640.75
|
| Rate for Payer: Amida Care Medicaid |
$114,640.75
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$257,941.69
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$114,640.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$114,640.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$137,568.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$114,640.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$114,640.75
|
| Rate for Payer: Healthfirst Commercial |
$263,266.00
|
| Rate for Payer: Healthfirst Essential Plan |
$257,941.69
|
| Rate for Payer: Healthfirst QHP |
$197,251.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$114,640.75
|
| Rate for Payer: SOMOS Essential |
$257,941.69
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$257,941.69
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$257,941.69
|
| Rate for Payer: United Healthcare Medicaid |
$114,640.75
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$114,640.75
|
|
|
Heart &/or lung transplant
|
Facility
|
IP
|
$431,334.00
|
|
|
Service Code
|
APR-DRG 0023
|
| Min. Negotiated Rate |
$132,017.17 |
| Max. Negotiated Rate |
$431,334.00 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$297,038.63
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$297,038.63
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$132,017.17
|
| Rate for Payer: Amida Care Medicaid |
$132,017.17
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$297,038.63
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$132,017.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$132,017.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$158,420.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$132,017.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$132,017.17
|
| Rate for Payer: Healthfirst Commercial |
$431,334.00
|
| Rate for Payer: Healthfirst Essential Plan |
$297,038.63
|
| Rate for Payer: Healthfirst QHP |
$268,219.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$132,017.17
|
| Rate for Payer: SOMOS Essential |
$297,038.63
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$297,038.63
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$297,038.63
|
| Rate for Payer: United Healthcare Medicaid |
$132,017.17
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$132,017.17
|
|
|
Heart &/or lung transplant
|
Facility
|
IP
|
$251,740.00
|
|
|
Service Code
|
APR-DRG 0021
|
| Min. Negotiated Rate |
$108,811.88 |
| Max. Negotiated Rate |
$251,740.00 |
| Rate for Payer: Affinity Essential Plan 1&2 |
$244,826.73
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$244,826.73
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$108,811.88
|
| Rate for Payer: Amida Care Medicaid |
$108,811.88
|
| Rate for Payer: EmblemHealth Essential Plan 1&2 |
$244,826.73
|
| Rate for Payer: EmblemHealth Essential Plan 3&4 |
$108,811.88
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$108,811.88
|
| Rate for Payer: Fidelis Qualified Health Plan |
$130,574.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$108,811.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$108,811.88
|
| Rate for Payer: Healthfirst Commercial |
$251,740.00
|
| Rate for Payer: Healthfirst Essential Plan |
$244,826.73
|
| Rate for Payer: Healthfirst QHP |
$181,134.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$108,811.88
|
| Rate for Payer: SOMOS Essential |
$244,826.73
|
| Rate for Payer: United Healthcare Essential Plan 1&2 |
$244,826.73
|
| Rate for Payer: United Healthcare Essential Plan 3&4 |
$244,826.73
|
| Rate for Payer: United Healthcare Medicaid |
$108,811.88
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$108,811.88
|
|
|
HEPARIN NA (PORK) LOCK FLSH PF 100 UNIT/ML IV SOLN
|
Facility
|
OP
|
$1.13
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
6425333333
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.90 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.62
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.02
|
| Rate for Payer: Aetna Government |
$0.02
|
| Rate for Payer: Brighton Health Commercial |
$0.85
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.90
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.77
|
| Rate for Payer: EmblemHealth Commercial |
$0.57
|
| Rate for Payer: Group Health Inc Commercial |
$0.57
|
| Rate for Payer: Group Health Inc Medicare |
$0.40
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.73
|
|
|
HEPARIN NA (PORK) LOCK FLSH PF 100 UNIT/ML IV SOLN
|
Facility
|
IP
|
$1.13
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
6425333333
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$0.57 |
| Max. Negotiated Rate |
$0.57 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.57
|
|
|
HEPARIN NA (PORK) LOCK FLSH PF 100 UNIT/ML IV SOLN
|
Facility
|
OP
|
$0.17
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
8290306424
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.13 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.09
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.02
|
| Rate for Payer: Aetna Government |
$0.02
|
| Rate for Payer: Brighton Health Commercial |
$0.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.13
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.11
|
| Rate for Payer: EmblemHealth Commercial |
$0.08
|
| Rate for Payer: Group Health Inc Commercial |
$0.08
|
| Rate for Payer: Group Health Inc Medicare |
$0.06
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.11
|
|
|
HEPARIN NA (PORK) LOCK FLSH PF 100 UNIT/ML IV SOLN
|
Facility
|
IP
|
$0.74
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
6425333335
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$0.37 |
| Max. Negotiated Rate |
$0.37 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.37
|
|
|
HEPARIN NA (PORK) LOCK FLSH PF 100 UNIT/ML IV SOLN
|
Facility
|
IP
|
$0.17
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
8290306424
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$0.08 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.08
|
|
|
HEPARIN NA (PORK) LOCK FLSH PF 100 UNIT/ML IV SOLN
|
Facility
|
OP
|
$0.74
|
|
|
Service Code
|
HCPCS J1642
|
| Hospital Charge Code |
6425333335
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.59 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.41
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.02
|
| Rate for Payer: Aetna Government |
$0.02
|
| Rate for Payer: Brighton Health Commercial |
$0.56
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.59
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.50
|
| Rate for Payer: EmblemHealth Commercial |
$0.37
|
| Rate for Payer: Group Health Inc Commercial |
$0.37
|
| Rate for Payer: Group Health Inc Medicare |
$0.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.37
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$0.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.48
|
|
