|
HEMI GREAT TOE IMPLANT MD
|
Facility
|
OP
|
$2,030.00
|
|
|
Service Code
|
HCPCS C1762
|
| Hospital Charge Code |
40200164
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$710.50 |
| Max. Negotiated Rate |
$2,131.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,116.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,879.82
|
| Rate for Payer: Aetna Government |
$1,879.82
|
| Rate for Payer: Brighton Health Commercial |
$1,218.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,015.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,167.25
|
| Rate for Payer: EmblemHealth Commercial |
$1,015.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,131.50
|
| Rate for Payer: Group Health Inc Commercial |
$1,015.00
|
| Rate for Payer: Group Health Inc Medicare |
$710.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,015.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,015.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,319.50
|
|
|
HEMI PHLANGECTOMY
|
Facility
|
IP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 28160
|
| Hospital Charge Code |
40082835
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,743.15
|
|
|
HEMI PHLANGECTOMY
|
Facility
|
OP
|
$8,291.05
|
|
|
Service Code
|
HCPCS 28160
|
| Hospital Charge Code |
40082835
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$6,218.29 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,743.15
|
| Rate for Payer: Aetna Government |
$3,743.15
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,620.20
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,620.20
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,620.20
|
| Rate for Payer: Brighton Health Commercial |
$6,218.29
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Cash Price |
$3,743.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,743.15
|
| 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: Elderplan Medicare Advantage |
$3,743.15
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,181.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,331.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,743.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,331.40
|
| Rate for Payer: Group Health Inc Commercial |
$3,743.15
|
| Rate for Payer: Group Health Inc Medicare |
$3,743.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,145.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,743.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,181.68
|
| Rate for Payer: Healthfirst QHP |
$3,743.15
|
| Rate for Payer: Humana Medicare |
$3,818.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,743.15
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,743.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,743.15
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,994.52
|
| Rate for Payer: Wellcare Medicare |
$3,555.99
|
|
|
HEMISECTION (INC ROOT REMOVAL) NO
|
Facility
|
OP
|
$425.25
|
|
|
Service Code
|
HCPCS D3920
|
| Hospital Charge Code |
42300815
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$212.62 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$233.89
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,018.19
|
| Rate for Payer: Aetna Government |
$1,018.19
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$712.73
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$712.73
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$712.73
|
| Rate for Payer: Brighton Health Commercial |
$318.94
|
| Rate for Payer: Cash Price |
$1,018.19
|
| Rate for Payer: Cash Price |
$1,018.19
|
| Rate for Payer: Cash Price |
$1,018.19
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,018.19
|
| 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 |
$1,018.19
|
| Rate for Payer: EmblemHealth Commercial |
$1,018.19
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$865.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$906.19
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,018.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$906.19
|
| Rate for Payer: Group Health Inc Commercial |
$1,018.19
|
| Rate for Payer: Group Health Inc Medicare |
$1,018.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$212.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,018.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$865.46
|
| Rate for Payer: Healthfirst QHP |
$1,018.19
|
| Rate for Payer: Humana Medicare |
$1,038.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,018.19
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,018.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,018.19
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$814.55
|
| Rate for Payer: Wellcare Medicare |
$967.28
|
|
|
HEMISECTION (INC ROOT REMOVAL) NO
|
Facility
|
IP
|
$425.25
|
|
|
Service Code
|
HCPCS D3920
|
| Hospital Charge Code |
42300815
|
|
Hospital Revenue Code
|
361
|
| Rate for Payer: Cash Price |
$1,018.19
|
|
|
HEMISPHERICAL ACETAB SHELL
|
Facility
|
OP
|
$3,106.60
|
|
| Hospital Charge Code |
40200356
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,087.31 |
| Max. Negotiated Rate |
$2,485.28 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,708.63
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,553.30
|
| Rate for Payer: Aetna Government |
$1,553.30
|
| Rate for Payer: Brighton Health Commercial |
$2,329.95
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$2,485.28
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2,112.49
|
| Rate for Payer: Group Health Inc Commercial |
$1,553.30
|
| Rate for Payer: Group Health Inc Medicare |
$1,087.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,553.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,553.30
|
|
|
HEMO/COMPOSITE-OUTPAT./INUNIT
|
Facility
|
IP
|
$1,938.50
|
|
|
Service Code
|
HCPCS 90935
|
| Hospital Charge Code |
42901821
|
|
Hospital Revenue Code
|
820
|
| Rate for Payer: Cash Price |
$808.11
|
|
|
HEMO/COMPOSITE-OUTPAT./INUNIT
|
Facility
|
OP
|
$1,938.50
|
|
|
Service Code
|
HCPCS 90935
|
| Hospital Charge Code |
42901821
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$435.00 |
| Max. Negotiated Rate |
$1,550.80 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$1,066.18
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$808.11
|
| Rate for Payer: Aetna Government |
$808.11
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$565.68
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$565.68
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$565.68
|
| Rate for Payer: Brighton Health Commercial |
$1,453.88
|
| Rate for Payer: Cash Price |
$808.11
|
| Rate for Payer: Cash Price |
$808.11
|
| Rate for Payer: Cash Price |
$808.11
|
| Rate for Payer: Cash Price |
$808.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$808.11
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,550.80
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$1,318.18
|
| Rate for Payer: Elderplan Medicare Advantage |
$808.11
|
| Rate for Payer: EmblemHealth Commercial |
$445.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$686.89
|
| Rate for Payer: Fidelis Essential Plan QHP |
$719.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$808.11
|
| Rate for Payer: Fidelis Qualified Health Plan |
$719.22
|
| Rate for Payer: Group Health Inc Commercial |
$650.00
|
| Rate for Payer: Group Health Inc Medicare |
$435.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$969.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$808.11
|
| Rate for Payer: Healthfirst Medicare Advantage |
$686.89
|
| Rate for Payer: Healthfirst QHP |
$808.11
|
| Rate for Payer: Humana Medicare |
$824.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$808.11
|
| Rate for Payer: United Healthcare Commercial |
$569.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$808.11
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$808.11
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$646.49
|
| Rate for Payer: Wellcare Medicare |
$767.70
|
|
|
HEMOCULT SLIDES
|
Facility
|
OP
|
$13.47
|
|
| Hospital Charge Code |
40207635
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.71 |
| Max. Negotiated Rate |
$10.78 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$7.41
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$6.74
|
| Rate for Payer: Aetna Government |
$6.74
|
| Rate for Payer: Brighton Health Commercial |
$10.10
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$10.78
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$9.16
|
| Rate for Payer: Group Health Inc Commercial |
$6.74
|
| Rate for Payer: Group Health Inc Medicare |
$4.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$6.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$6.74
|
|
|
HEMOFILTER
|
Facility
|
OP
|
$171.16
|
|
| Hospital Charge Code |
40202440
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$59.91 |
| Max. Negotiated Rate |
$136.93 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$94.14
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$85.58
|
| Rate for Payer: Aetna Government |
$85.58
|
| Rate for Payer: Brighton Health Commercial |
$128.37
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$136.93
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$116.39
|
| Rate for Payer: Group Health Inc Commercial |
$85.58
|
| Rate for Payer: Group Health Inc Medicare |
$59.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$85.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$85.58
|
|
|
HEMOGLOBIN A1C
|
Facility
|
OP
|
$24.28
|
|
|
Service Code
|
HCPCS 83036
|
| Hospital Charge Code |
40602589
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$18.21 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13.35
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$9.71
|
| Rate for Payer: Aetna Government |
$9.71
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$6.80
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$6.80
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$6.80
|
| Rate for Payer: Brighton Health Commercial |
$18.21
|
| Rate for Payer: Cash Price |
$9.71
|
| Rate for Payer: Cash Price |
$9.71
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.71
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$15.43
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$13.06
|
| Rate for Payer: Elderplan Medicare Advantage |
$9.71
|
| Rate for Payer: EmblemHealth Commercial |
$9.71
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.25
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.71
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.64
|
| Rate for Payer: Group Health Inc Commercial |
$9.71
|
| Rate for Payer: Group Health Inc Medicare |
$9.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.71
|
| Rate for Payer: Healthfirst QHP |
$9.71
|
| Rate for Payer: Humana Medicare |
$9.90
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.71
|
| Rate for Payer: United Healthcare Commercial |
$12.29
|
| Rate for Payer: United Healthcare Medicare Advantage |
$9.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.71
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$7.77
|
| Rate for Payer: Wellcare Medicare |
$8.74
|
|
|
HEMOGLOBIN A1C
|
Facility
|
IP
|
$24.28
|
|
|
Service Code
|
HCPCS 83036
|
| Hospital Charge Code |
40602589
|
|
Hospital Revenue Code
|
301
|
| Rate for Payer: Cash Price |
$9.71
|
|
|
HEMOGLOBIN A1C LEVEL >9.0%
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS 3046F
|
| Hospital Charge Code |
30307859
|
|
Hospital Revenue Code
|
969
|
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.01
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.01
|
| Rate for Payer: Aetna Government |
$0.01
|
| Rate for Payer: Brighton Health Commercial |
$0.01
|
| 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 |
$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
|
|
|
HEMOGLOBIN CHROMOTOGRAPHY
|
Facility
|
IP
|
$45.15
|
|
|
Service Code
|
HCPCS 83021
|
| Hospital Charge Code |
30305608
|
|
Hospital Revenue Code
|
301
|
| Rate for Payer: Cash Price |
$18.06
|
|
|
HEMOGLOBIN CHROMOTOGRAPHY
|
Facility
|
OP
|
$45.15
|
|
|
Service Code
|
HCPCS 83021
|
| Hospital Charge Code |
30305608
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.64 |
| Max. Negotiated Rate |
$33.86 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$24.83
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$18.06
|
| Rate for Payer: Aetna Government |
$18.06
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$12.64
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$12.64
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$12.64
|
| Rate for Payer: Brighton Health Commercial |
$33.86
|
| Rate for Payer: Cash Price |
$18.06
|
| Rate for Payer: Cash Price |
$18.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$18.06
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$28.70
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$24.29
|
| Rate for Payer: Elderplan Medicare Advantage |
$18.06
|
| Rate for Payer: EmblemHealth Commercial |
$18.06
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$15.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$16.07
|
| Rate for Payer: Fidelis Medicare Advantage |
$18.06
|
| Rate for Payer: Fidelis Qualified Health Plan |
$16.07
|
| Rate for Payer: Group Health Inc Commercial |
$18.06
|
| Rate for Payer: Group Health Inc Medicare |
$18.06
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18.06
|
| Rate for Payer: Healthfirst QHP |
$18.06
|
| Rate for Payer: Humana Medicare |
$18.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$18.06
|
| Rate for Payer: United Healthcare Commercial |
$22.87
|
| Rate for Payer: United Healthcare Medicare Advantage |
$18.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$18.06
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$14.45
|
| Rate for Payer: Wellcare Medicare |
$16.25
|
|
|
HEMOGLOBIN ELECTROPHORESIS
|
Facility
|
OP
|
$32.18
|
|
|
Service Code
|
HCPCS 83020
|
| Hospital Charge Code |
40607028
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.01 |
| Max. Negotiated Rate |
$24.14 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.70
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.87
|
| Rate for Payer: Aetna Government |
$12.87
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$9.01
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$9.01
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$9.01
|
| Rate for Payer: Brighton Health Commercial |
$24.14
|
| Rate for Payer: Cash Price |
$12.87
|
| Rate for Payer: Cash Price |
$12.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12.87
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.48
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.32
|
| Rate for Payer: Elderplan Medicare Advantage |
$12.87
|
| Rate for Payer: EmblemHealth Commercial |
$12.87
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$12.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.45
|
| Rate for Payer: Group Health Inc Commercial |
$12.87
|
| Rate for Payer: Group Health Inc Medicare |
$12.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12.87
|
| Rate for Payer: Healthfirst QHP |
$12.87
|
| Rate for Payer: Humana Medicare |
$13.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12.87
|
| Rate for Payer: United Healthcare Commercial |
$16.31
|
| Rate for Payer: United Healthcare Medicare Advantage |
$12.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12.87
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10.30
|
| Rate for Payer: Wellcare Medicare |
$11.58
|
|
|
HEMOGLOBIN ELECTROPHORESIS
|
Facility
|
IP
|
$32.18
|
|
|
Service Code
|
HCPCS 83020
|
| Hospital Charge Code |
40607028
|
|
Hospital Revenue Code
|
301
|
| Rate for Payer: Cash Price |
$12.87
|
|
|
HEMOGLOBIN/HEMATOCRIT
|
Facility
|
OP
|
$5.93
|
|
|
Service Code
|
HCPCS 85018
|
| Hospital Charge Code |
40621521
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.66 |
| Max. Negotiated Rate |
$4.45 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$3.26
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2.37
|
| Rate for Payer: Aetna Government |
$2.37
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1.66
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1.66
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1.66
|
| Rate for Payer: Brighton Health Commercial |
$4.45
|
| Rate for Payer: Cash Price |
$2.37
|
| Rate for Payer: Cash Price |
$2.37
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2.37
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.76
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$3.18
|
| Rate for Payer: Elderplan Medicare Advantage |
$2.37
|
| Rate for Payer: EmblemHealth Commercial |
$2.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2.01
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2.11
|
| Rate for Payer: Fidelis Medicare Advantage |
$2.37
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2.11
|
| Rate for Payer: Group Health Inc Commercial |
$2.37
|
| Rate for Payer: Group Health Inc Medicare |
$2.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2.37
|
| Rate for Payer: Healthfirst QHP |
$2.37
|
| Rate for Payer: Humana Medicare |
$2.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2.37
|
| Rate for Payer: United Healthcare Commercial |
$3.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$2.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2.37
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1.90
|
| Rate for Payer: Wellcare Medicare |
$2.13
|
|
|
HEMOGLOBIN/HEMATOCRIT
|
Facility
|
IP
|
$5.93
|
|
|
Service Code
|
HCPCS 85018
|
| Hospital Charge Code |
40621521
|
|
Hospital Revenue Code
|
305
|
| Rate for Payer: Cash Price |
$2.37
|
|
|
HEMO IV TUBING
|
Facility
|
OP
|
$4.38
|
|
| Hospital Charge Code |
42905345
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.53 |
| Max. Negotiated Rate |
$3.50 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2.41
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$2.19
|
| Rate for Payer: Aetna Government |
$2.19
|
| Rate for Payer: Brighton Health Commercial |
$3.28
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$3.50
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$2.98
|
| Rate for Payer: Group Health Inc Commercial |
$2.19
|
| Rate for Payer: Group Health Inc Medicare |
$1.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2.19
|
|
|
HEMOPAD
|
Facility
|
OP
|
$1,273.63
|
|
| Hospital Charge Code |
40207018
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$445.77 |
| Max. Negotiated Rate |
$1,018.90 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$700.50
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$636.82
|
| Rate for Payer: Aetna Government |
$636.82
|
| Rate for Payer: Brighton Health Commercial |
$955.22
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$1,018.90
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$866.07
|
| Rate for Payer: Group Health Inc Commercial |
$636.82
|
| Rate for Payer: Group Health Inc Medicare |
$445.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$636.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$636.82
|
|
|
HEMORRHOIDAL PREPARATION SUPP
|
Facility
|
OP
|
$0.18
|
|
| Hospital Charge Code |
41653368
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.09
|
| Rate for Payer: Aetna Government |
$0.09
|
| Rate for Payer: Brighton Health Commercial |
$0.14
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.14
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.12
|
| Rate for Payer: Group Health Inc Commercial |
$0.09
|
| Rate for Payer: Group Health Inc Medicare |
$0.06
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.12
|
|
|
HEMORRHOIDAL PREPARATION SUPP
|
Facility
|
OP
|
$0.18
|
|
| Hospital Charge Code |
41643368
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$0.09
|
| Rate for Payer: Aetna Government |
$0.09
|
| Rate for Payer: Brighton Health Commercial |
$0.14
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$0.14
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$0.12
|
| Rate for Payer: Group Health Inc Commercial |
$0.09
|
| Rate for Payer: Group Health Inc Medicare |
$0.06
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$0.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$0.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.12
|
|
|
HEMORRHOIDECT, I&E CPLX/EXTENSIVE
|
Facility
|
OP
|
$7,099.93
|
|
|
Service Code
|
HCPCS 46260
|
| Hospital Charge Code |
40019979
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,468.00 |
| Max. Negotiated Rate |
$5,324.95 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$3,246.99
|
| Rate for Payer: Aetna Government |
$3,246.99
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$2,272.89
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$2,272.89
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$2,272.89
|
| Rate for Payer: Brighton Health Commercial |
$5,324.95
|
| Rate for Payer: Cash Price |
$3,246.99
|
| Rate for Payer: Cash Price |
$3,246.99
|
| Rate for Payer: Cash Price |
$3,246.99
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,246.99
|
| 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 |
$3,246.99
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,759.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,889.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,246.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,889.82
|
| Rate for Payer: Group Health Inc Commercial |
$3,246.99
|
| Rate for Payer: Group Health Inc Medicare |
$3,246.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,549.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,246.99
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,759.94
|
| Rate for Payer: Healthfirst QHP |
$3,246.99
|
| Rate for Payer: Humana Medicare |
$3,311.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,246.99
|
| Rate for Payer: United Healthcare Commercial |
$1,468.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$3,246.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,246.99
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$2,597.59
|
| Rate for Payer: Wellcare Medicare |
$3,084.64
|
|
|
HEMORRHOIDECT, I&E CPLX/EXTENSIVE
|
Facility
|
IP
|
$7,099.93
|
|
|
Service Code
|
HCPCS 46260
|
| Hospital Charge Code |
40019979
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$3,246.99
|
|
