|
HEALIX 4.5
|
Facility
|
OP
|
$1,085.00
|
|
| Hospital Charge Code |
64901998
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$379.75 |
| Max. Negotiated Rate |
$868.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$596.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$542.50
|
| Rate for Payer: Aetna Government |
$542.50
|
| Rate for Payer: Brighton Health Commercial |
$813.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$868.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$737.80
|
| Rate for Payer: Group Health Inc Commercial |
$542.50
|
| Rate for Payer: Group Health Inc Medicare |
$379.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$542.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$542.50
|
|
|
HEALIX 6.5
|
Facility
|
OP
|
$1,085.00
|
|
| Hospital Charge Code |
64902318
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$379.75 |
| Max. Negotiated Rate |
$868.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$596.75
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$542.50
|
| Rate for Payer: Aetna Government |
$542.50
|
| Rate for Payer: Brighton Health Commercial |
$813.75
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$868.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$737.80
|
| Rate for Payer: Group Health Inc Commercial |
$542.50
|
| Rate for Payer: Group Health Inc Medicare |
$379.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$542.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$542.50
|
|
|
HEALIX PEEK ANCHOR ORTHCRD 4.5MM
|
Facility
|
OP
|
$682.00
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40209698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.35 |
| Max. Negotiated Rate |
$716.10 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$375.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$69.35
|
| Rate for Payer: Aetna Government |
$69.35
|
| Rate for Payer: Brighton Health Commercial |
$409.20
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$341.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$392.15
|
| Rate for Payer: EmblemHealth Commercial |
$341.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$716.10
|
| Rate for Payer: Group Health Inc Commercial |
$341.00
|
| Rate for Payer: Group Health Inc Medicare |
$238.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$341.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$341.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$443.30
|
|
|
HEALIX PEEK ANCHOR ORTHCRD 4.5MM
|
Facility
|
IP
|
$682.00
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40209698
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$341.00 |
| Max. Negotiated Rate |
$341.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$341.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$341.00
|
|
|
HEALIX PEEK ANCHOR ORTHCRD SIZE 2
|
Facility
|
OP
|
$682.00
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40209699
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$69.35 |
| Max. Negotiated Rate |
$716.10 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$375.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$69.35
|
| Rate for Payer: Aetna Government |
$69.35
|
| Rate for Payer: Brighton Health Commercial |
$409.20
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$341.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$392.15
|
| Rate for Payer: EmblemHealth Commercial |
$341.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$716.10
|
| Rate for Payer: Group Health Inc Commercial |
$341.00
|
| Rate for Payer: Group Health Inc Medicare |
$238.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$341.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$341.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$443.30
|
|
|
HEALIX PEEK ANCHOR ORTHCRD SIZE 2
|
Facility
|
IP
|
$682.00
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
40209699
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$341.00 |
| Max. Negotiated Rate |
$341.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$341.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$341.00
|
|
|
HEALON 10MG/ML - .85ML
|
Facility
|
OP
|
$134.00
|
|
| Hospital Charge Code |
41657084
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$46.90 |
| Max. Negotiated Rate |
$107.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$73.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$67.00
|
| Rate for Payer: Aetna Government |
$67.00
|
| Rate for Payer: Brighton Health Commercial |
$100.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$107.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$91.12
|
| Rate for Payer: Group Health Inc Commercial |
$67.00
|
| Rate for Payer: Group Health Inc Medicare |
$46.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$67.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$67.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$87.10
|
|
|
HEALON 10MG/ML - .85ML
|
Facility
|
OP
|
$134.00
|
|
| Hospital Charge Code |
41647084
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$46.90 |
| Max. Negotiated Rate |
$107.20 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$73.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$67.00
|
| Rate for Payer: Aetna Government |
$67.00
|
| Rate for Payer: Brighton Health Commercial |
$100.50
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$107.20
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$91.12
|
| Rate for Payer: Group Health Inc Commercial |
$67.00
|
| Rate for Payer: Group Health Inc Medicare |
$46.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$67.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$67.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$87.10
|
|
|
HEALOS II BNE GRFT STRPS 10ML
|
Facility
|
OP
|
$3,780.00
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
40209700
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$322.77 |
| Max. Negotiated Rate |
$3,969.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,079.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$322.77
|
| Rate for Payer: Aetna Government |
$322.77
|
| Rate for Payer: Brighton Health Commercial |
$2,268.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,890.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,173.50
|
| Rate for Payer: EmblemHealth Commercial |
$1,890.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,969.00
|
| Rate for Payer: Group Health Inc Commercial |
$1,890.00
|
| Rate for Payer: Group Health Inc Medicare |
$1,323.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,890.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,890.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,457.00
|
|
|
HEALOS II BNE GRFT STRPS 10ML
|
Facility
|
IP
|
$3,780.00
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
40209700
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,890.00 |
| Max. Negotiated Rate |
$1,890.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,890.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,890.00
|
|
|
HEALOS II BONE GRFT STRIPS 5 ML
|
Facility
|
OP
|
$1,120.00
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
40209701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$322.77 |
| Max. Negotiated Rate |
$1,176.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$616.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$322.77
|
| Rate for Payer: Aetna Government |
$322.77
|
| Rate for Payer: Brighton Health Commercial |
$672.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$560.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$644.00
|
| Rate for Payer: EmblemHealth Commercial |
$560.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,176.00
|
| Rate for Payer: Group Health Inc Commercial |
$560.00
|
| Rate for Payer: Group Health Inc Medicare |
$392.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$560.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$560.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$728.00
|
|
|
HEALOS II BONE GRFT STRIPS 5 ML
|
Facility
|
IP
|
$1,120.00
|
|
|
Service Code
|
HCPCS C1768
|
| Hospital Charge Code |
40209701
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$560.00 |
| Max. Negotiated Rate |
$560.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$560.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$560.00
|
|
|
HEARING AID CHECK -BINAURAL
|
Facility
|
OP
|
$177.19
|
|
|
Service Code
|
HCPCS 92593
|
| Hospital Charge Code |
42004523
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$31.14 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$97.45
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$31.14
|
| Rate for Payer: Aetna Government |
$31.14
|
| Rate for Payer: Brighton Health Commercial |
$132.89
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$141.75
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$120.49
|
| Rate for Payer: Group Health Inc Commercial |
$88.60
|
| Rate for Payer: Group Health Inc Medicare |
$62.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$88.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$88.60
|
| Rate for Payer: United Healthcare Commercial |
$158.00
|
|
|
HEARING AID CHECK -MONAURAL
|
Facility
|
OP
|
$106.31
|
|
|
Service Code
|
HCPCS 92592
|
| Hospital Charge Code |
42004522
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$18.79 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$58.47
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$18.79
|
| Rate for Payer: Aetna Government |
$18.79
|
| Rate for Payer: Brighton Health Commercial |
$79.73
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$85.05
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$72.29
|
| Rate for Payer: Group Health Inc Commercial |
$53.16
|
| Rate for Payer: Group Health Inc Medicare |
$37.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$53.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$53.16
|
| Rate for Payer: United Healthcare Commercial |
$158.00
|
|
|
HEARING AID EVAL BINAURAL
|
Facility
|
OP
|
$212.63
|
|
|
Service Code
|
HCPCS 92591
|
| Hospital Charge Code |
42004521
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$60.74 |
| Max. Negotiated Rate |
$170.10 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$116.95
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$60.74
|
| Rate for Payer: Aetna Government |
$60.74
|
| Rate for Payer: Brighton Health Commercial |
$159.47
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$170.10
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$144.59
|
| Rate for Payer: Group Health Inc Commercial |
$106.32
|
| Rate for Payer: Group Health Inc Medicare |
$74.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$106.32
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$106.32
|
| Rate for Payer: United Healthcare Commercial |
$158.00
|
|
|
HEARING AID EVAL -MONAURAL
|
Facility
|
OP
|
$141.75
|
|
|
Service Code
|
HCPCS 92590
|
| Hospital Charge Code |
42004520
|
|
Hospital Revenue Code
|
470
|
| Min. Negotiated Rate |
$47.77 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$77.96
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$47.77
|
| Rate for Payer: Aetna Government |
$47.77
|
| Rate for Payer: Brighton Health Commercial |
$106.31
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$113.40
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$96.39
|
| Rate for Payer: Group Health Inc Commercial |
$70.88
|
| Rate for Payer: Group Health Inc Medicare |
$49.61
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$70.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$70.88
|
| Rate for Payer: United Healthcare Commercial |
$158.00
|
|
|
HEARING SCREENING
|
Facility
|
IP
|
$419.03
|
|
|
Service Code
|
HCPCS 92557
|
| Hospital Charge Code |
41904507
|
|
Hospital Revenue Code
|
471
|
| Rate for Payer: Cash Price |
$180.64
|
|
|
HEARING SCREENING
|
Facility
|
OP
|
$419.03
|
|
|
Service Code
|
HCPCS 92557
|
| Hospital Charge Code |
41904507
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$126.45 |
| Max. Negotiated Rate |
$335.22 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$230.47
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$180.64
|
| Rate for Payer: Aetna Government |
$180.64
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$126.45
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$126.45
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$126.45
|
| Rate for Payer: Brighton Health Commercial |
$314.27
|
| Rate for Payer: Cash Price |
$180.64
|
| Rate for Payer: Cash Price |
$180.64
|
| Rate for Payer: Cash Price |
$180.64
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$180.64
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$335.22
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$284.94
|
| Rate for Payer: Elderplan Medicare Advantage |
$180.64
|
| Rate for Payer: EmblemHealth Commercial |
$180.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$153.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$160.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$180.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$160.77
|
| Rate for Payer: Group Health Inc Commercial |
$180.64
|
| Rate for Payer: Group Health Inc Medicare |
$180.64
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$209.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$180.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$153.54
|
| Rate for Payer: Healthfirst QHP |
$180.64
|
| Rate for Payer: Humana Medicare |
$184.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$180.64
|
| Rate for Payer: United Healthcare Commercial |
$158.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$180.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$180.64
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$144.51
|
| Rate for Payer: Wellcare Medicare |
$171.61
|
|
|
HEARING SCREEN-PURE TONE,AIR ONLY
|
Facility
|
OP
|
$82.22
|
|
|
Service Code
|
HCPCS 92551
|
| Hospital Charge Code |
42003110
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$158.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$45.22
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$10.97
|
| Rate for Payer: Aetna Government |
$10.97
|
| Rate for Payer: Brighton Health Commercial |
$61.66
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$65.78
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$55.91
|
| Rate for Payer: Group Health Inc Commercial |
$41.11
|
| Rate for Payer: Group Health Inc Medicare |
$28.78
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$41.11
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$41.11
|
| Rate for Payer: United Healthcare Commercial |
$158.00
|
|
|
HEART FAILURE AND SHOCK WITH CC
|
Facility
|
IP
|
$26,407.22
|
|
|
Service Code
|
MSDRG 292
|
| Min. Negotiated Rate |
$7,344.49 |
| Max. Negotiated Rate |
$26,407.22 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$12,629.09
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$19,205.25
|
| Rate for Payer: Aetna Government |
$19,205.25
|
| Rate for Payer: Brighton Health Commercial |
$12,419.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$19,589.36
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$14,790.90
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$12,206.08
|
| Rate for Payer: Elderplan Medicare Advantage |
$18,244.99
|
| Rate for Payer: EmblemHealth Commercial |
$7,344.49
|
| Rate for Payer: Fidelis Medicare Advantage |
$19,205.25
|
| Rate for Payer: Group Health Inc Commercial |
$19,205.25
|
| Rate for Payer: Group Health Inc Medicare |
$19,205.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$19,205.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8,930.44
|
| Rate for Payer: Humana Medicare |
$26,407.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$19,205.25
|
| Rate for Payer: United Healthcare Commercial |
$17,033.22
|
| Rate for Payer: United Healthcare Medicare Advantage |
$19,205.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$19,205.25
|
| Rate for Payer: Wellcare Medicare |
$18,244.99
|
|
|
HEART FAILURE AND SHOCK WITH MCC
|
Facility
|
IP
|
$34,556.72
|
|
|
Service Code
|
MSDRG 291
|
| Min. Negotiated Rate |
$11,009.40 |
| Max. Negotiated Rate |
$34,556.72 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$18,931.11
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$25,132.16
|
| Rate for Payer: Aetna Government |
$25,132.16
|
| Rate for Payer: Brighton Health Commercial |
$18,616.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$25,634.80
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$22,171.67
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$18,297.01
|
| Rate for Payer: Elderplan Medicare Advantage |
$23,875.55
|
| Rate for Payer: EmblemHealth Commercial |
$11,009.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$25,132.16
|
| Rate for Payer: Group Health Inc Commercial |
$25,132.16
|
| Rate for Payer: Group Health Inc Medicare |
$25,132.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$25,132.16
|
| Rate for Payer: Healthfirst Medicare Advantage |
$11,686.45
|
| Rate for Payer: Humana Medicare |
$34,556.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$25,132.16
|
| Rate for Payer: United Healthcare Commercial |
$25,532.92
|
| Rate for Payer: United Healthcare Medicare Advantage |
$25,132.16
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$25,132.16
|
| Rate for Payer: Wellcare Medicare |
$23,875.55
|
|
|
HEART FAILURE AND SHOCK WITHOUT CC/MCC
|
Facility
|
IP
|
$20,782.24
|
|
|
Service Code
|
MSDRG 293
|
| Min. Negotiated Rate |
$4,814.86 |
| Max. Negotiated Rate |
$20,782.24 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$8,279.32
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$15,114.36
|
| Rate for Payer: Aetna Government |
$15,114.36
|
| Rate for Payer: Brighton Health Commercial |
$8,141.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15,416.65
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$9,696.54
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$8,002.00
|
| Rate for Payer: Elderplan Medicare Advantage |
$14,358.64
|
| Rate for Payer: EmblemHealth Commercial |
$4,814.86
|
| Rate for Payer: Fidelis Medicare Advantage |
$15,114.36
|
| Rate for Payer: Group Health Inc Commercial |
$15,114.36
|
| Rate for Payer: Group Health Inc Medicare |
$15,114.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15,114.36
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7,028.18
|
| Rate for Payer: Humana Medicare |
$20,782.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15,114.36
|
| Rate for Payer: United Healthcare Commercial |
$11,166.55
|
| Rate for Payer: United Healthcare Medicare Advantage |
$15,114.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15,114.36
|
| Rate for Payer: Wellcare Medicare |
$14,358.64
|
|
|
HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC
|
Facility
|
IP
|
$538,909.86
|
|
|
Service Code
|
MSDRG 001
|
| Min. Negotiated Rate |
$178,148.26 |
| Max. Negotiated Rate |
$538,909.86 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$399,568.86
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$383,114.54
|
| Rate for Payer: Aetna Government |
$383,114.54
|
| Rate for Payer: Brighton Health Commercial |
$392,929.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$390,776.83
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$467,965.72
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$386,185.40
|
| Rate for Payer: Elderplan Medicare Advantage |
$363,958.81
|
| Rate for Payer: EmblemHealth Commercial |
$232,370.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$383,114.54
|
| Rate for Payer: Group Health Inc Commercial |
$383,114.54
|
| Rate for Payer: Group Health Inc Medicare |
$383,114.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$383,114.54
|
| Rate for Payer: Healthfirst Medicare Advantage |
$178,148.26
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$383,114.54
|
| Rate for Payer: United Healthcare Commercial |
$538,909.86
|
| Rate for Payer: United Healthcare Medicare Advantage |
$383,114.54
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$383,114.54
|
| Rate for Payer: Wellcare Medicare |
$363,958.81
|
|
|
HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC
|
Facility
|
IP
|
$243,498.42
|
|
|
Service Code
|
MSDRG 002
|
| Min. Negotiated Rate |
$82,361.49 |
| Max. Negotiated Rate |
$243,498.42 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$180,539.25
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$177,121.48
|
| Rate for Payer: Aetna Government |
$177,121.48
|
| Rate for Payer: Brighton Health Commercial |
$177,539.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$180,663.91
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$211,443.36
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$174,492.14
|
| Rate for Payer: Elderplan Medicare Advantage |
$168,265.41
|
| Rate for Payer: EmblemHealth Commercial |
$104,993.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$177,121.48
|
| Rate for Payer: Group Health Inc Commercial |
$177,121.48
|
| Rate for Payer: Group Health Inc Medicare |
$177,121.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$177,121.48
|
| Rate for Payer: Healthfirst Medicare Advantage |
$82,361.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$177,121.48
|
| Rate for Payer: United Healthcare Commercial |
$243,498.42
|
| Rate for Payer: United Healthcare Medicare Advantage |
$177,121.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$177,121.48
|
| Rate for Payer: Wellcare Medicare |
$168,265.41
|
|
|
HEATED AEROSOL THERAPY
|
Facility
|
OP
|
$32.60
|
|
| Hospital Charge Code |
40302550
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.41 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.93
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16.30
|
| Rate for Payer: Aetna Government |
$16.30
|
| Rate for Payer: Brighton Health Commercial |
$24.45
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$26.08
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$22.17
|
| Rate for Payer: Group Health Inc Commercial |
$16.30
|
| Rate for Payer: Group Health Inc Medicare |
$11.41
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.30
|
|
