|
EP REMOVAL OF PG ALONE
|
Facility
|
IP
|
$23,145.25
|
|
|
Service Code
|
HCPCS 33233
|
| Hospital Charge Code |
66574525
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$9,824.59
|
|
|
EP REPAIR SINGLE ELECTRODE
|
Facility
|
OP
|
$9,037.83
|
|
|
Service Code
|
HCPCS 33218
|
| Hospital Charge Code |
66574514
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,835.00 |
| Max. Negotiated Rate |
$6,778.37 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,541.28
|
| Rate for Payer: Aetna Government |
$4,541.28
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,178.90
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,178.90
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,178.90
|
| Rate for Payer: Brighton Health Commercial |
$6,778.37
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,541.28
|
| 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 |
$4,541.28
|
| Rate for Payer: EmblemHealth Commercial |
$4,541.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,860.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4,041.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,541.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4,041.74
|
| Rate for Payer: Group Health Inc Commercial |
$4,541.28
|
| Rate for Payer: Group Health Inc Medicare |
$4,541.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,518.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,541.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,860.09
|
| Rate for Payer: Healthfirst QHP |
$4,541.28
|
| Rate for Payer: Humana Medicare |
$4,632.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,541.28
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,541.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,541.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,633.02
|
| Rate for Payer: Wellcare Medicare |
$4,314.22
|
|
|
EP REPAIR SINGLE ELECTRODE
|
Facility
|
IP
|
$9,037.83
|
|
|
Service Code
|
HCPCS 33218
|
| Hospital Charge Code |
66574514
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$4,541.28
|
|
|
EP REPLACE SNG/DUAL ICD
|
Facility
|
IP
|
$68,791.68
|
|
|
Service Code
|
HCPCS 33240
|
| Hospital Charge Code |
66574528
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$27,258.51
|
|
|
EP REPLACE SNG/DUAL ICD
|
Facility
|
OP
|
$68,791.68
|
|
|
Service Code
|
HCPCS 33240
|
| Hospital Charge Code |
66574528
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,477.75 |
| Max. Negotiated Rate |
$51,593.76 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$44,507.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$27,258.51
|
| Rate for Payer: Aetna Government |
$27,258.51
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$19,080.96
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$19,080.96
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$19,080.96
|
| Rate for Payer: Brighton Health Commercial |
$51,593.76
|
| Rate for Payer: Cash Price |
$27,258.51
|
| Rate for Payer: Cash Price |
$27,258.51
|
| Rate for Payer: Cash Price |
$27,258.51
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$27,258.51
|
| 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 |
$27,258.51
|
| Rate for Payer: EmblemHealth Commercial |
$27,258.51
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$23,169.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$24,260.07
|
| Rate for Payer: Fidelis Medicare Advantage |
$27,258.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24,260.07
|
| Rate for Payer: Group Health Inc Commercial |
$27,258.51
|
| Rate for Payer: Group Health Inc Medicare |
$27,258.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34,395.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$27,258.51
|
| Rate for Payer: Healthfirst Medicare Advantage |
$23,169.73
|
| Rate for Payer: Healthfirst QHP |
$27,258.51
|
| Rate for Payer: Humana Medicare |
$27,803.68
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$27,258.51
|
| Rate for Payer: United Healthcare Commercial |
$4,446.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27,258.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$27,258.51
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$21,806.81
|
| Rate for Payer: Wellcare Medicare |
$25,895.58
|
|
|
EP REPO PRE IMPLNT/ICD ELEC
|
Facility
|
OP
|
$8,393.53
|
|
|
Service Code
|
HCPCS 33215
|
| Hospital Charge Code |
66574511
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,835.00 |
| Max. Negotiated Rate |
$6,295.15 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,686.08
|
| Rate for Payer: Aetna Government |
$3,686.08
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,580.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,580.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,580.26
|
| Rate for Payer: Brighton Health Commercial |
$6,295.15
|
| Rate for Payer: Cash Price |
$3,686.08
|
| Rate for Payer: Cash Price |
$3,686.08
|
| Rate for Payer: Cash Price |
$3,686.08
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,686.08
|
| 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 |
$3,686.08
|
| Rate for Payer: EmblemHealth Commercial |
$3,686.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,133.17
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,280.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,686.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,280.61
|
| Rate for Payer: Group Health Inc Commercial |
$3,686.08
|
| Rate for Payer: Group Health Inc Medicare |
$3,686.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,196.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,686.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,133.17
|
| Rate for Payer: Healthfirst QHP |
$3,686.08
|
| Rate for Payer: Humana Medicare |
$3,759.80
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,686.08
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,686.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,686.08
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,948.86
|
| Rate for Payer: Wellcare Medicare |
$3,501.78
|
|
|
EP REPO PRE IMPLNT/ICD ELEC
|
Facility
|
IP
|
$8,393.53
|
|
|
Service Code
|
HCPCS 33215
|
| Hospital Charge Code |
66574511
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$3,686.08
|
|
|
EP REPO PREV IMP LEFT VENTR
|
Facility
|
OP
|
$8,393.53
|
|
|
Service Code
|
HCPCS 33226
|
| Hospital Charge Code |
66574520
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,835.00 |
| Max. Negotiated Rate |
$6,295.15 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,686.08
|
| Rate for Payer: Aetna Government |
$3,686.08
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,580.26
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,580.26
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,580.26
|
| Rate for Payer: Brighton Health Commercial |
$6,295.15
|
| Rate for Payer: Cash Price |
$3,686.08
|
| Rate for Payer: Cash Price |
$3,686.08
|
| Rate for Payer: Cash Price |
$3,686.08
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,686.08
|
| 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 |
$3,686.08
|
| Rate for Payer: EmblemHealth Commercial |
$3,686.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,133.17
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,280.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,686.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,280.61
|
| Rate for Payer: Group Health Inc Commercial |
$3,686.08
|
| Rate for Payer: Group Health Inc Medicare |
$3,686.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,196.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,686.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,133.17
|
| Rate for Payer: Healthfirst QHP |
$3,686.08
|
| Rate for Payer: Humana Medicare |
$3,759.80
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,686.08
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,686.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,686.08
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,948.86
|
| Rate for Payer: Wellcare Medicare |
$3,501.78
|
|
|
EP REPO PREV IMP LEFT VENTR
|
Facility
|
IP
|
$8,393.53
|
|
|
Service Code
|
HCPCS 33226
|
| Hospital Charge Code |
66574520
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$3,686.08
|
|
|
EP REPOSG PERQ R/L HRT VAD
|
Facility
|
OP
|
$523.22
|
|
|
Service Code
|
HCPCS 33993
|
| Hospital Charge Code |
66574543
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$183.13 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$287.77
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$204.15
|
| Rate for Payer: Aetna Government |
$204.15
|
| Rate for Payer: Brighton Health Commercial |
$392.42
|
| 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: Group Health Inc Commercial |
$261.61
|
| Rate for Payer: Group Health Inc Medicare |
$183.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$261.61
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$261.61
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
EP RE SKIN POCK CRD-DFB
|
Facility
|
OP
|
$4,914.88
|
|
|
Service Code
|
HCPCS 33223
|
| Hospital Charge Code |
66574517
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,409.00 |
| Max. Negotiated Rate |
$3,686.16 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,108.87
|
| Rate for Payer: Aetna Government |
$2,108.87
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,476.21
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,476.21
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,476.21
|
| Rate for Payer: Brighton Health Commercial |
$3,686.16
|
| 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 |
$2,108.87
|
| 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 Medicare Advantage |
$1,792.54
|
| Rate for Payer: Healthfirst QHP |
$2,108.87
|
| Rate for Payer: Humana Medicare |
$2,151.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,108.87
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare 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
|
|
|
EP RE SKIN POCK CRD-DFB
|
Facility
|
IP
|
$4,914.88
|
|
|
Service Code
|
HCPCS 33223
|
| Hospital Charge Code |
66574517
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$2,108.87
|
|
|
EP REV/REL SKIN POCKET PM
|
Facility
|
OP
|
$4,914.88
|
|
|
Service Code
|
HCPCS 33222
|
| Hospital Charge Code |
66574516
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,409.00 |
| Max. Negotiated Rate |
$3,686.16 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,888.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2,108.87
|
| Rate for Payer: Aetna Government |
$2,108.87
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,476.21
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,476.21
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,476.21
|
| Rate for Payer: Brighton Health Commercial |
$3,686.16
|
| 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 |
$2,108.87
|
| 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 Medicare Advantage |
$1,792.54
|
| Rate for Payer: Healthfirst QHP |
$2,108.87
|
| Rate for Payer: Humana Medicare |
$2,151.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,108.87
|
| Rate for Payer: United Healthcare Commercial |
$1,409.00
|
| Rate for Payer: United Healthcare 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
|
|
|
EP REV/REL SKIN POCKET PM
|
Facility
|
IP
|
$4,914.88
|
|
|
Service Code
|
HCPCS 33222
|
| Hospital Charge Code |
66574516
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$2,108.87
|
|
|
EP RMV CRD-DFB P-GEN ONLY
|
Facility
|
IP
|
$9,037.83
|
|
|
Service Code
|
HCPCS 33241
|
| Hospital Charge Code |
66574529
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$4,541.28
|
|
|
EP RMV CRD-DFB P-GEN ONLY
|
Facility
|
OP
|
$9,037.83
|
|
|
Service Code
|
HCPCS 33241
|
| Hospital Charge Code |
66574529
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,835.00 |
| Max. Negotiated Rate |
$6,778.37 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,541.28
|
| Rate for Payer: Aetna Government |
$4,541.28
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,178.90
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,178.90
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,178.90
|
| Rate for Payer: Brighton Health Commercial |
$6,778.37
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,541.28
|
| 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 |
$4,541.28
|
| Rate for Payer: EmblemHealth Commercial |
$4,541.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,860.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4,041.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,541.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4,041.74
|
| Rate for Payer: Group Health Inc Commercial |
$4,541.28
|
| Rate for Payer: Group Health Inc Medicare |
$4,541.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,518.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,541.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,860.09
|
| Rate for Payer: Healthfirst QHP |
$4,541.28
|
| Rate for Payer: Humana Medicare |
$4,632.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,541.28
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,541.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,541.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,633.02
|
| Rate for Payer: Wellcare Medicare |
$4,314.22
|
|
|
EP RMV DUAL LEAD AND PG
|
Facility
|
IP
|
$9,037.83
|
|
|
Service Code
|
HCPCS 33235
|
| Hospital Charge Code |
66574527
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$4,541.28
|
|
|
EP RMV DUAL LEAD AND PG
|
Facility
|
OP
|
$9,037.83
|
|
|
Service Code
|
HCPCS 33235
|
| Hospital Charge Code |
66574527
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,835.00 |
| Max. Negotiated Rate |
$6,778.37 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,541.28
|
| Rate for Payer: Aetna Government |
$4,541.28
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,178.90
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,178.90
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,178.90
|
| Rate for Payer: Brighton Health Commercial |
$6,778.37
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,541.28
|
| 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 |
$4,541.28
|
| Rate for Payer: EmblemHealth Commercial |
$4,541.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,860.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4,041.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,541.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4,041.74
|
| Rate for Payer: Group Health Inc Commercial |
$4,541.28
|
| Rate for Payer: Group Health Inc Medicare |
$4,541.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,518.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,541.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,860.09
|
| Rate for Payer: Healthfirst QHP |
$4,541.28
|
| Rate for Payer: Humana Medicare |
$4,632.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,541.28
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,541.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,541.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,633.02
|
| Rate for Payer: Wellcare Medicare |
$4,314.22
|
|
|
EP RMV IMPLANTABLE LOOP
|
Facility
|
IP
|
$1,847.58
|
|
|
Service Code
|
HCPCS 33286
|
| Hospital Charge Code |
66574538
|
|
Hospital Revenue Code
|
481
|
| Rate for Payer: Cash Price |
$813.63
|
|
|
EP RMV IMPLANTABLE LOOP
|
Facility
|
OP
|
$1,847.58
|
|
|
Service Code
|
HCPCS 33286
|
| Hospital Charge Code |
66574538
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$569.54 |
| Max. Negotiated Rate |
$6,937.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,412.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$813.63
|
| Rate for Payer: Aetna Government |
$813.63
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$569.54
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$569.54
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$569.54
|
| Rate for Payer: Brighton Health Commercial |
$6,937.00
|
| Rate for Payer: Cash Price |
$813.63
|
| Rate for Payer: Cash Price |
$813.63
|
| Rate for Payer: Cash Price |
$813.63
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$813.63
|
| 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 |
$813.63
|
| Rate for Payer: EmblemHealth Commercial |
$813.63
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$691.59
|
| Rate for Payer: Fidelis Essential Plan QHP |
$724.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$813.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$724.13
|
| Rate for Payer: Group Health Inc Commercial |
$813.63
|
| Rate for Payer: Group Health Inc Medicare |
$813.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$923.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$813.63
|
| Rate for Payer: Healthfirst Medicare Advantage |
$691.59
|
| Rate for Payer: Healthfirst QHP |
$813.63
|
| Rate for Payer: Humana Medicare |
$829.90
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$813.63
|
| Rate for Payer: United Healthcare Commercial |
$1,188.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$813.63
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$813.63
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$650.90
|
| Rate for Payer: Wellcare Medicare |
$772.95
|
|
|
EP RMVL PERQ LEFT HEART VAD
|
Facility
|
OP
|
$598.87
|
|
|
Service Code
|
HCPCS 33992
|
| Hospital Charge Code |
66574542
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$209.60 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$329.38
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$232.79
|
| Rate for Payer: Aetna Government |
$232.79
|
| Rate for Payer: Brighton Health Commercial |
$449.15
|
| 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: Group Health Inc Commercial |
$299.44
|
| Rate for Payer: Group Health Inc Medicare |
$209.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$299.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$299.44
|
| Rate for Payer: United Healthcare Commercial |
$1,496.00
|
|
|
EP RMV OF ICD SYSTM
|
Facility
|
IP
|
$9,037.83
|
|
|
Service Code
|
HCPCS 33244
|
| Hospital Charge Code |
66574530
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$4,541.28
|
|
|
EP RMV OF ICD SYSTM
|
Facility
|
OP
|
$9,037.83
|
|
|
Service Code
|
HCPCS 33244
|
| Hospital Charge Code |
66574530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,835.00 |
| Max. Negotiated Rate |
$6,778.37 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,485.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$4,541.28
|
| Rate for Payer: Aetna Government |
$4,541.28
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$3,178.90
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$3,178.90
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$3,178.90
|
| Rate for Payer: Brighton Health Commercial |
$6,778.37
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Cash Price |
$4,541.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,541.28
|
| 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 |
$4,541.28
|
| Rate for Payer: EmblemHealth Commercial |
$4,541.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,860.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4,041.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,541.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4,041.74
|
| Rate for Payer: Group Health Inc Commercial |
$4,541.28
|
| Rate for Payer: Group Health Inc Medicare |
$4,541.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,518.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,541.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,860.09
|
| Rate for Payer: Healthfirst QHP |
$4,541.28
|
| Rate for Payer: Humana Medicare |
$4,632.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,541.28
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$4,541.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,541.28
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$3,633.02
|
| Rate for Payer: Wellcare Medicare |
$4,314.22
|
|
|
EP RMV/REP CRD-DFB DUAL
|
Facility
|
OP
|
$68,791.68
|
|
|
Service Code
|
HCPCS 33263
|
| Hospital Charge Code |
66574535
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,477.75 |
| Max. Negotiated Rate |
$51,593.76 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$44,507.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$27,258.51
|
| Rate for Payer: Aetna Government |
$27,258.51
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$19,080.96
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$19,080.96
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$19,080.96
|
| Rate for Payer: Brighton Health Commercial |
$51,593.76
|
| Rate for Payer: Cash Price |
$27,258.51
|
| Rate for Payer: Cash Price |
$27,258.51
|
| Rate for Payer: Cash Price |
$27,258.51
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$27,258.51
|
| 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 |
$27,258.51
|
| Rate for Payer: EmblemHealth Commercial |
$27,258.51
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$23,169.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$24,260.07
|
| Rate for Payer: Fidelis Medicare Advantage |
$27,258.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24,260.07
|
| Rate for Payer: Group Health Inc Commercial |
$27,258.51
|
| Rate for Payer: Group Health Inc Medicare |
$27,258.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34,395.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$27,258.51
|
| Rate for Payer: Healthfirst Medicare Advantage |
$23,169.73
|
| Rate for Payer: Healthfirst QHP |
$27,258.51
|
| Rate for Payer: Humana Medicare |
$27,803.68
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$27,258.51
|
| Rate for Payer: United Healthcare Commercial |
$4,446.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$27,258.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$27,258.51
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$21,806.81
|
| Rate for Payer: Wellcare Medicare |
$25,895.58
|
|
|
EP RMV/REP CRD-DFB DUAL
|
Facility
|
IP
|
$68,791.68
|
|
|
Service Code
|
HCPCS 33263
|
| Hospital Charge Code |
66574535
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$27,258.51
|
|
