|
HALOPERIDOL LACTATE 2 MG/ML PO CONC [3585]
|
Facility
|
OP
|
$0.88
|
|
|
Service Code
|
NDC 00904711270
|
| Hospital Charge Code |
00904711270
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$0.71 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.49
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.44
|
| Rate for Payer: Aetna Government |
$0.44
|
| Rate for Payer: Brighton Health Commercial |
$0.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.71
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.60
|
| Rate for Payer: Group Health Inc Commercial |
$0.44
|
| Rate for Payer: Group Health Inc Medicare |
$0.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.57
|
|
|
HALOPERIDOL LACTATE 2 MG/ML PO CONC [3585]
|
Facility
|
OP
|
$0.88
|
|
|
Service Code
|
NDC 00904711241
|
| Hospital Charge Code |
00904711241
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$0.71 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.49
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.44
|
| Rate for Payer: Aetna Government |
$0.44
|
| Rate for Payer: Brighton Health Commercial |
$0.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.71
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.60
|
| Rate for Payer: Group Health Inc Commercial |
$0.44
|
| Rate for Payer: Group Health Inc Medicare |
$0.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.57
|
|
|
HALOPERIDOL LACTATE 2 MG/ML PO CONC [3585]
|
Facility
|
OP
|
$0.84
|
|
|
Service Code
|
NDC 00121058105
|
| Hospital Charge Code |
00121058105
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.29 |
| Max. Negotiated Rate |
$0.67 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.46
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.42
|
| Rate for Payer: Aetna Government |
$0.42
|
| Rate for Payer: Brighton Health Commercial |
$0.63
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.67
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.57
|
| Rate for Payer: Group Health Inc Commercial |
$0.42
|
| Rate for Payer: Group Health Inc Medicare |
$0.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.42
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.54
|
|
|
HALOPERIDOL LACTATE 2 MG/ML PO CONC [3585]
|
Facility
|
OP
|
$0.45
|
|
|
Service Code
|
NDC 00121058104
|
| Hospital Charge Code |
00121058104
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$0.36 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.23
|
| Rate for Payer: Aetna Government |
$0.23
|
| Rate for Payer: Brighton Health Commercial |
$0.34
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.36
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.31
|
| Rate for Payer: Group Health Inc Commercial |
$0.23
|
| Rate for Payer: Group Health Inc Medicare |
$0.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.23
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.29
|
|
|
HALOPERIDOL LACTATE 5 MG/ML IJ SOLN [3584]
|
Facility
|
OP
|
$7.19
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
63323047401
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$5.75 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.46
|
| Rate for Payer: Aetna Government |
$1.46
|
| Rate for Payer: Brighton Health Commercial |
$5.39
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.75
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.89
|
| Rate for Payer: Group Health Inc Commercial |
$3.59
|
| Rate for Payer: Group Health Inc Medicare |
$2.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.59
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1.26
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1.34
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1.34
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.67
|
|
|
HALOPERIDOL LACTATE 5 MG/ML IJ SOLN [3584]
|
Facility
|
OP
|
$1.44
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
67457042600
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$1.46 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.46
|
| Rate for Payer: Aetna Government |
$1.46
|
| Rate for Payer: Brighton Health Commercial |
$1.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.98
|
| Rate for Payer: Group Health Inc Commercial |
$0.72
|
| Rate for Payer: Group Health Inc Medicare |
$0.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1.26
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1.34
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1.34
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.94
|
|
|
HALOPERIDOL LACTATE 5 MG/ML IJ SOLN [3584]
|
Facility
|
OP
|
$6.90
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
63323047410
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$5.52 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.80
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.46
|
| Rate for Payer: Aetna Government |
$1.46
|
| Rate for Payer: Brighton Health Commercial |
$5.18
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$5.52
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.69
|
| Rate for Payer: Group Health Inc Commercial |
$3.45
|
| Rate for Payer: Group Health Inc Medicare |
$2.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.45
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.45
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1.26
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1.34
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1.34
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.48
|
|
|
HALOPERIDOL LACTATE 5 MG/ML IJ SOLN [3584]
|
Facility
|
OP
|
$1.44
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
67457042612
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$1.46 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.79
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.46
|
| Rate for Payer: Aetna Government |
$1.46
|
| Rate for Payer: Brighton Health Commercial |
$1.08
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1.15
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.98
|
| Rate for Payer: Group Health Inc Commercial |
$0.72
|
| Rate for Payer: Group Health Inc Medicare |
$0.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1.26
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1.34
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1.34
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.94
|
|
|
HALOPERIDOL LACTATE 5 MG/ML IJ SOLN [3584]
|
Facility
|
OP
|
$6.00
|
|
|
Service Code
|
HCPCS J1630
|
| Hospital Charge Code |
25021080601
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.26 |
| Max. Negotiated Rate |
$4.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1.46
|
| Rate for Payer: Aetna Government |
$1.46
|
| Rate for Payer: Brighton Health Commercial |
$4.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$4.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$4.08
|
| Rate for Payer: Group Health Inc Commercial |
$3.00
|
| Rate for Payer: Group Health Inc Medicare |
$2.10
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.00
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1.26
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1.34
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1.34
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.90
|
|
|
HALOPERIDOL/PLACEBO
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS J1631 Q0
|
| Hospital Charge Code |
41640267
|
|
Hospital Revenue Code
|
636
|
| Max. Negotiated Rate |
$9.57 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.01
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.57
|
| Rate for Payer: Aetna Government |
$9.57
|
| Rate for Payer: Brighton Health Commercial |
$0.01
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.01
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.01
|
| Rate for Payer: Group Health Inc Commercial |
$0.01
|
| Rate for Payer: Group Health Inc Medicare |
$0.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.01
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.01
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$7.15
|
| Rate for Payer: SOMOS Essential |
$7.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.01
|
|
|
HALOPERIDOL/PLACEBO
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS J1631 Q0
|
| Hospital Charge Code |
41650267
|
|
Hospital Revenue Code
|
636
|
| Max. Negotiated Rate |
$9.57 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.01
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.57
|
| Rate for Payer: Aetna Government |
$9.57
|
| Rate for Payer: Brighton Health Commercial |
$0.01
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.01
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.01
|
| Rate for Payer: Group Health Inc Commercial |
$0.01
|
| Rate for Payer: Group Health Inc Medicare |
$0.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.01
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.01
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$7.15
|
| Rate for Payer: SOMOS Essential |
$7.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.01
|
|
|
HALOPERIDOL/PLACEBO
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS J1631 Q0
|
| Hospital Charge Code |
41640267
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.01
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.01
|
|
|
HALOPERIDOL/PLACEBO
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS J1631 Q0
|
| Hospital Charge Code |
41650267
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.01
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.01
|
|
|
HALOPERIDOL, SERUM
|
Facility
|
IP
|
$40.04
|
|
|
Service Code
|
HCPCS 80173
|
| Hospital Charge Code |
30305424
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$15.78
|
|
|
HALOPERIDOL, SERUM
|
Facility
|
OP
|
$40.04
|
|
|
Service Code
|
HCPCS 80173
|
| Hospital Charge Code |
30305424
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.05 |
| Max. Negotiated Rate |
$30.03 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$22.02
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15.78
|
| Rate for Payer: Aetna Government |
$15.78
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$11.05
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$11.05
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$11.05
|
| Rate for Payer: Brighton Health Commercial |
$30.03
|
| Rate for Payer: Cash Price |
$15.78
|
| Rate for Payer: Cash Price |
$15.78
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15.78
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$23.14
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$19.58
|
| Rate for Payer: Elderplan Medicare Advantage |
$15.78
|
| Rate for Payer: EmblemHealth Commercial |
$15.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$13.41
|
| Rate for Payer: Fidelis Essential Plan QHP |
$14.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$15.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$14.04
|
| Rate for Payer: Group Health Inc Commercial |
$15.78
|
| Rate for Payer: Group Health Inc Medicare |
$15.78
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$20.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.78
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.78
|
| Rate for Payer: Healthfirst QHP |
$15.78
|
| Rate for Payer: Humana Medicare |
$16.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15.78
|
| Rate for Payer: United Healthcare Commercial |
$18.44
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15.78
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15.78
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$12.62
|
| Rate for Payer: Wellcare Medicare |
$14.20
|
|
|
HANDLE DISPOSAB LP MEDIUM
|
Facility
|
OP
|
$10.56
|
|
| Hospital Charge Code |
64903796
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$8.45 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5.81
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.28
|
| Rate for Payer: Aetna Government |
$5.28
|
| Rate for Payer: Brighton Health Commercial |
$7.92
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.45
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.18
|
| Rate for Payer: Group Health Inc Commercial |
$5.28
|
| Rate for Payer: Group Health Inc Medicare |
$3.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.28
|
|
|
HANDLE DISPOSAB LP PEDIATRIC
|
Facility
|
OP
|
$10.56
|
|
| Hospital Charge Code |
64903798
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.70 |
| Max. Negotiated Rate |
$8.45 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$5.81
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$5.28
|
| Rate for Payer: Aetna Government |
$5.28
|
| Rate for Payer: Brighton Health Commercial |
$7.92
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$8.45
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$7.18
|
| Rate for Payer: Group Health Inc Commercial |
$5.28
|
| Rate for Payer: Group Health Inc Medicare |
$3.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5.28
|
|
|
HANDLE DISPOSAB LP STUBBY
|
Facility
|
OP
|
$211.25
|
|
| Hospital Charge Code |
64903800
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$73.94 |
| Max. Negotiated Rate |
$169.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$116.19
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$105.62
|
| Rate for Payer: Aetna Government |
$105.62
|
| Rate for Payer: Brighton Health Commercial |
$158.44
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$169.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$143.65
|
| Rate for Payer: Group Health Inc Commercial |
$105.62
|
| Rate for Payer: Group Health Inc Medicare |
$73.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$105.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$105.62
|
|
|
HANDLE KNIFE NO.3
|
Facility
|
OP
|
$38.80
|
|
| Hospital Charge Code |
40200451
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.58 |
| Max. Negotiated Rate |
$31.04 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$21.34
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$19.40
|
| Rate for Payer: Aetna Government |
$19.40
|
| Rate for Payer: Brighton Health Commercial |
$29.10
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$31.04
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$26.38
|
| Rate for Payer: Group Health Inc Commercial |
$19.40
|
| Rate for Payer: Group Health Inc Medicare |
$13.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$19.40
|
|
|
HAND MITTEN, PADDED COTTON,L/L
|
Facility
|
OP
|
$39.78
|
|
| Hospital Charge Code |
64902125
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$31.82 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$21.88
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$19.89
|
| Rate for Payer: Aetna Government |
$19.89
|
| Rate for Payer: Brighton Health Commercial |
$29.84
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$31.82
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$27.05
|
| Rate for Payer: Group Health Inc Commercial |
$19.89
|
| Rate for Payer: Group Health Inc Medicare |
$13.92
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$19.89
|
|
|
HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC
|
Facility
|
IP
|
$40,984.45
|
|
|
Service Code
|
MSDRG 513
|
| Min. Negotiated Rate |
$13,860.19 |
| Max. Negotiated Rate |
$40,984.45 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$23,901.65
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$29,806.87
|
| Rate for Payer: Aetna Government |
$29,806.87
|
| Rate for Payer: Brighton Health Commercial |
$23,504.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$30,403.01
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$27,993.05
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$23,101.07
|
| Rate for Payer: Elderplan Medicare Advantage |
$28,316.53
|
| Rate for Payer: EmblemHealth Commercial |
$13,900.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$29,806.87
|
| Rate for Payer: Group Health Inc Commercial |
$29,806.87
|
| Rate for Payer: Group Health Inc Medicare |
$29,806.87
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$29,806.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13,860.19
|
| Rate for Payer: Humana Medicare |
$40,984.45
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$29,806.87
|
| Rate for Payer: United Healthcare Commercial |
$32,236.83
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29,806.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$29,806.87
|
| Rate for Payer: Wellcare Medicare |
$28,316.53
|
|
|
HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$29,934.73
|
|
|
Service Code
|
MSDRG 514
|
| Min. Negotiated Rate |
$8,930.86 |
| Max. Negotiated Rate |
$29,934.73 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$15,356.92
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$21,770.71
|
| Rate for Payer: Aetna Government |
$21,770.71
|
| Rate for Payer: Brighton Health Commercial |
$15,101.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$22,206.12
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$17,985.66
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$14,842.54
|
| Rate for Payer: Elderplan Medicare Advantage |
$20,682.17
|
| Rate for Payer: EmblemHealth Commercial |
$8,930.86
|
| Rate for Payer: Fidelis Medicare Advantage |
$21,770.71
|
| Rate for Payer: Group Health Inc Commercial |
$21,770.71
|
| Rate for Payer: Group Health Inc Medicare |
$21,770.71
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21,770.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10,123.38
|
| Rate for Payer: Humana Medicare |
$29,934.73
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$21,770.71
|
| Rate for Payer: United Healthcare Commercial |
$20,712.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$21,770.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21,770.71
|
| Rate for Payer: Wellcare Medicare |
$20,682.17
|
|
|
HAND PROCEDURES FOR INJURIES
|
Facility
|
IP
|
$45,953.49
|
|
|
Service Code
|
MSDRG 906
|
| Min. Negotiated Rate |
$15,540.63 |
| Max. Negotiated Rate |
$45,953.49 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$27,744.19
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$33,420.72
|
| Rate for Payer: Aetna Government |
$33,420.72
|
| Rate for Payer: Brighton Health Commercial |
$27,283.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$34,089.13
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$32,493.35
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$26,814.91
|
| Rate for Payer: Elderplan Medicare Advantage |
$31,749.68
|
| Rate for Payer: EmblemHealth Commercial |
$16,134.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$33,420.72
|
| Rate for Payer: Group Health Inc Commercial |
$33,420.72
|
| Rate for Payer: Group Health Inc Medicare |
$33,420.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$33,420.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15,540.63
|
| Rate for Payer: Humana Medicare |
$45,953.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$33,420.72
|
| Rate for Payer: United Healthcare Commercial |
$37,419.38
|
| Rate for Payer: United Healthcare Medicare Advantage |
$33,420.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$33,420.72
|
| Rate for Payer: Wellcare Medicare |
$31,749.68
|
|
|
HAPTOGLOBIN_
|
Facility
|
OP
|
$31.45
|
|
|
Service Code
|
HCPCS 83010
|
| Hospital Charge Code |
40609083
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$23.59 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.30
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.58
|
| Rate for Payer: Aetna Government |
$12.58
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$8.81
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$8.81
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$8.81
|
| Rate for Payer: Brighton Health Commercial |
$23.59
|
| Rate for Payer: Cash Price |
$12.58
|
| Rate for Payer: Cash Price |
$12.58
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12.58
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$19.99
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$16.92
|
| Rate for Payer: Elderplan Medicare Advantage |
$12.58
|
| Rate for Payer: EmblemHealth Commercial |
$12.58
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$12.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.20
|
| Rate for Payer: Group Health Inc Commercial |
$12.58
|
| Rate for Payer: Group Health Inc Medicare |
$12.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12.58
|
| Rate for Payer: Healthfirst QHP |
$12.58
|
| Rate for Payer: Humana Medicare |
$12.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12.58
|
| Rate for Payer: United Healthcare Commercial |
$15.93
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.58
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12.58
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10.06
|
| Rate for Payer: Wellcare Medicare |
$11.32
|
|
|
HAPTOGLOBIN_
|
Facility
|
IP
|
$31.45
|
|
|
Service Code
|
HCPCS 83010
|
| Hospital Charge Code |
40609083
|
|
Hospital Revenue Code
|
300
|
| Rate for Payer: Cash Price |
$12.58
|
|
