|
HIB CONJUGATE (VFC) 0.5ML VIAL
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS 90647
|
| Hospital Charge Code |
41649560
|
|
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
|
|
|
HIB CONJUGATE (VFC) 0.5ML VIAL
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS 90647
|
| Hospital Charge Code |
41659559
|
|
Hospital Revenue Code
|
636
|
| Max. Negotiated Rate |
$28.48 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.01
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$28.48
|
| Rate for Payer: Aetna Government |
$28.48
|
| 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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.01
|
|
|
HIB CONJUGATE (VFC) 0.5ML VIAL
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS 90647
|
| Hospital Charge Code |
41649559
|
|
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
|
|
|
HIB CONJUGATE (VFC) 0.5ML VIAL
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS 90647
|
| Hospital Charge Code |
41659560
|
|
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
|
|
|
HIB CONJUGATE (VFC) 0.5ML VIAL
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS 90647
|
| Hospital Charge Code |
41649559
|
|
Hospital Revenue Code
|
636
|
| Max. Negotiated Rate |
$28.48 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.01
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$28.48
|
| Rate for Payer: Aetna Government |
$28.48
|
| 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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.01
|
|
|
HIB CONJUGATE (VFC) 0.5ML VIAL
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS 90647
|
| Hospital Charge Code |
41659560
|
|
Hospital Revenue Code
|
636
|
| Max. Negotiated Rate |
$28.48 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.01
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$28.48
|
| Rate for Payer: Aetna Government |
$28.48
|
| 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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.01
|
|
|
HIB CONJUGATE (VFC) 0.5ML VIAL
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS 90647
|
| Hospital Charge Code |
41659559
|
|
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
|
|
|
HIB CONJUGATE (VFC) 0.5ML VIAL
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS 90647
|
| Hospital Charge Code |
41649560
|
|
Hospital Revenue Code
|
636
|
| Max. Negotiated Rate |
$28.48 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$0.01
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$28.48
|
| Rate for Payer: Aetna Government |
$28.48
|
| 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: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$0.01
|
|
|
HI COLONIC TRAY
|
Facility
|
OP
|
$25.52
|
|
| Hospital Charge Code |
40202420
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.93 |
| Max. Negotiated Rate |
$20.42 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$14.04
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.76
|
| Rate for Payer: Aetna Government |
$12.76
|
| Rate for Payer: Brighton Health Commercial |
$19.14
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.42
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.35
|
| Rate for Payer: Group Health Inc Commercial |
$12.76
|
| Rate for Payer: Group Health Inc Medicare |
$8.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.76
|
|
|
HIGH ANGLE CAPS
|
Facility
|
OP
|
$312.50
|
|
| Hospital Charge Code |
64904759
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$109.38 |
| Max. Negotiated Rate |
$250.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$171.88
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$156.25
|
| Rate for Payer: Aetna Government |
$156.25
|
| Rate for Payer: Brighton Health Commercial |
$234.38
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$250.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$212.50
|
| Rate for Payer: Group Health Inc Commercial |
$156.25
|
| Rate for Payer: Group Health Inc Medicare |
$109.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$156.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$156.25
|
|
|
HIGH ENERGY ESWT PLANTAR
|
Facility
|
IP
|
$4,105.13
|
|
|
Service Code
|
HCPCS 28890
|
| Hospital Charge Code |
40029701
|
|
Hospital Revenue Code
|
360
|
| Rate for Payer: Cash Price |
$1,858.61
|
|
|
HIGH ENERGY ESWT PLANTAR
|
Facility
|
OP
|
$4,105.13
|
|
|
Service Code
|
HCPCS 28890
|
| Hospital Charge Code |
40029701
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,301.03 |
| Max. Negotiated Rate |
$3,078.85 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$2,134.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$1,858.61
|
| Rate for Payer: Aetna Government |
$1,858.61
|
| Rate for Payer: Affinity Essential Plan 1&2 |
$1,301.03
|
| Rate for Payer: Affinity Essential Plan 3&4 |
$1,301.03
|
| Rate for Payer: Affinity Medicaid/CHP/HARP |
$1,301.03
|
| Rate for Payer: Brighton Health Commercial |
$3,078.85
|
| Rate for Payer: Cash Price |
$1,858.61
|
| Rate for Payer: Cash Price |
$1,858.61
|
| Rate for Payer: Cash Price |
$1,858.61
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,858.61
|
| 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 |
$1,858.61
|
| Rate for Payer: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,579.82
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,654.16
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,858.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,654.16
|
| Rate for Payer: Group Health Inc Commercial |
$1,858.61
|
| Rate for Payer: Group Health Inc Medicare |
$1,858.61
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,052.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,858.61
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,579.82
|
| Rate for Payer: Healthfirst QHP |
$1,858.61
|
| Rate for Payer: Humana Medicare |
$1,895.78
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,858.61
|
| Rate for Payer: United Healthcare Commercial |
$1,835.00
|
| Rate for Payer: United Healthcare Medicare Advantage |
$1,858.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,858.61
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$1,486.89
|
| Rate for Payer: Wellcare Medicare |
$1,765.68
|
|
|
HILAN ROSEN BURR 11
|
Facility
|
OP
|
$768.00
|
|
| Hospital Charge Code |
40200475
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$268.80 |
| Max. Negotiated Rate |
$614.40 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$422.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$384.00
|
| Rate for Payer: Aetna Government |
$384.00
|
| Rate for Payer: Brighton Health Commercial |
$576.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$614.40
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$522.24
|
| Rate for Payer: Group Health Inc Commercial |
$384.00
|
| Rate for Payer: Group Health Inc Medicare |
$268.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$384.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$384.00
|
|
|
HINGE BOLT LONG
|
Facility
|
OP
|
$177.45
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
64907444
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$62.11 |
| Max. Negotiated Rate |
$186.32 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$97.60
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$88.72
|
| Rate for Payer: Aetna Government |
$88.72
|
| Rate for Payer: Brighton Health Commercial |
$106.47
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$88.72
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$102.03
|
| Rate for Payer: EmblemHealth Commercial |
$88.72
|
| Rate for Payer: Fidelis Medicare Advantage |
$186.32
|
| Rate for Payer: Group Health Inc Commercial |
$88.72
|
| Rate for Payer: Group Health Inc Medicare |
$62.11
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$88.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$88.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$115.34
|
|
|
HINGE BOLT LONG
|
Facility
|
IP
|
$177.45
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
64907444
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$88.72 |
| Max. Negotiated Rate |
$88.72 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$88.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$88.72
|
|
|
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC
|
Facility
|
IP
|
$49,639.25
|
|
|
Service Code
|
MSDRG 481
|
| Min. Negotiated Rate |
$16,787.09 |
| Max. Negotiated Rate |
$49,639.25 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$30,594.40
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$36,101.27
|
| Rate for Payer: Aetna Government |
$36,101.27
|
| Rate for Payer: Brighton Health Commercial |
$30,086.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$36,823.30
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$35,831.45
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$29,569.65
|
| Rate for Payer: Elderplan Medicare Advantage |
$34,296.21
|
| Rate for Payer: EmblemHealth Commercial |
$17,792.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$36,101.27
|
| Rate for Payer: Group Health Inc Commercial |
$36,101.27
|
| Rate for Payer: Group Health Inc Medicare |
$36,101.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$36,101.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$16,787.09
|
| Rate for Payer: Humana Medicare |
$49,639.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$36,101.27
|
| Rate for Payer: United Healthcare Commercial |
$41,263.54
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36,101.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$36,101.27
|
| Rate for Payer: Wellcare Medicare |
$34,296.21
|
|
|
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC
|
Facility
|
IP
|
$66,304.38
|
|
|
Service Code
|
MSDRG 480
|
| Min. Negotiated Rate |
$22,422.94 |
| Max. Negotiated Rate |
$66,304.38 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$43,481.53
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$48,221.37
|
| Rate for Payer: Aetna Government |
$48,221.37
|
| Rate for Payer: Brighton Health Commercial |
$42,759.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$49,185.80
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$50,924.55
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$42,025.13
|
| Rate for Payer: Elderplan Medicare Advantage |
$45,810.30
|
| Rate for Payer: EmblemHealth Commercial |
$25,286.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$48,221.37
|
| Rate for Payer: Group Health Inc Commercial |
$48,221.37
|
| Rate for Payer: Group Health Inc Medicare |
$48,221.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$48,221.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22,422.94
|
| Rate for Payer: Humana Medicare |
$66,304.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$48,221.37
|
| Rate for Payer: United Healthcare Commercial |
$58,644.77
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48,221.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$48,221.37
|
| Rate for Payer: Wellcare Medicare |
$45,810.30
|
|
|
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC
|
Facility
|
IP
|
$40,362.85
|
|
|
Service Code
|
MSDRG 482
|
| Min. Negotiated Rate |
$13,620.50 |
| Max. Negotiated Rate |
$40,362.85 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$23,420.96
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$29,354.80
|
| Rate for Payer: Aetna Government |
$29,354.80
|
| Rate for Payer: Brighton Health Commercial |
$23,031.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$29,941.90
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$27,430.08
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$22,636.48
|
| Rate for Payer: Elderplan Medicare Advantage |
$27,887.06
|
| Rate for Payer: EmblemHealth Commercial |
$13,620.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$29,354.80
|
| Rate for Payer: Group Health Inc Commercial |
$29,354.80
|
| Rate for Payer: Group Health Inc Medicare |
$29,354.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$29,354.80
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13,649.98
|
| Rate for Payer: Humana Medicare |
$40,362.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$29,354.80
|
| Rate for Payer: United Healthcare Commercial |
$31,588.51
|
| Rate for Payer: United Healthcare Medicare Advantage |
$29,354.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$29,354.80
|
| Rate for Payer: Wellcare Medicare |
$27,887.06
|
|
|
HIP ARCOS REV SYSTEM
|
Facility
|
OP
|
$24,140.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
64907048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$339.17 |
| Max. Negotiated Rate |
$25,347.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$13,277.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$339.17
|
| Rate for Payer: Aetna Government |
$339.17
|
| Rate for Payer: Brighton Health Commercial |
$14,484.00
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$12,070.00
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$13,880.50
|
| Rate for Payer: EmblemHealth Commercial |
$12,070.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$25,347.00
|
| Rate for Payer: Group Health Inc Commercial |
$12,070.00
|
| Rate for Payer: Group Health Inc Medicare |
$8,449.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12,070.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12,070.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15,691.00
|
|
|
HIP ARCOS REV SYSTEM
|
Facility
|
IP
|
$24,140.00
|
|
|
Service Code
|
HCPCS C1776
|
| Hospital Charge Code |
64907048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$12,070.00 |
| Max. Negotiated Rate |
$12,070.00 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12,070.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12,070.00
|
|
|
HIP ARTHROGRAM WITH ANESTHESIA
|
Facility
|
OP
|
$1,027.56
|
|
|
Service Code
|
HCPCS 27095
|
| Hospital Charge Code |
40019471
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$83.34 |
| Max. Negotiated Rate |
$2,915.00 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$342.00
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$83.34
|
| Rate for Payer: Aetna Government |
$83.34
|
| Rate for Payer: Brighton Health Commercial |
$770.67
|
| 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: EmblemHealth Commercial |
$1,505.00
|
| Rate for Payer: Group Health Inc Commercial |
$513.78
|
| Rate for Payer: Group Health Inc Medicare |
$359.65
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$513.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$513.78
|
| Rate for Payer: United Healthcare Commercial |
$1,113.00
|
|
|
HIP PLATE
|
Facility
|
OP
|
$269.68
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40202130
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$94.39 |
| Max. Negotiated Rate |
$283.16 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$148.32
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$134.20
|
| Rate for Payer: Aetna Government |
$134.20
|
| Rate for Payer: Brighton Health Commercial |
$161.81
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$134.84
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$155.07
|
| Rate for Payer: EmblemHealth Commercial |
$134.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$283.16
|
| Rate for Payer: Group Health Inc Commercial |
$134.84
|
| Rate for Payer: Group Health Inc Medicare |
$94.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$134.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$134.84
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$175.29
|
|
|
HIP PLATE
|
Facility
|
IP
|
$269.68
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
40202130
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$134.84 |
| Max. Negotiated Rate |
$134.84 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$134.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$134.84
|
|
|
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC
|
Facility
|
IP
|
$67,168.13
|
|
|
Service Code
|
MSDRG 521
|
| Min. Negotiated Rate |
$22,715.04 |
| Max. Negotiated Rate |
$67,168.13 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$44,149.48
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$48,849.55
|
| Rate for Payer: Aetna Government |
$48,849.55
|
| Rate for Payer: Brighton Health Commercial |
$43,415.90
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$49,826.54
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$51,706.84
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$42,670.70
|
| Rate for Payer: Elderplan Medicare Advantage |
$46,407.07
|
| Rate for Payer: EmblemHealth Commercial |
$25,675.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$48,849.55
|
| Rate for Payer: Group Health Inc Commercial |
$48,849.55
|
| Rate for Payer: Group Health Inc Medicare |
$48,849.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$48,849.55
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22,715.04
|
| Rate for Payer: Humana Medicare |
$67,168.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$48,849.55
|
| Rate for Payer: United Healthcare Commercial |
$59,545.66
|
| Rate for Payer: United Healthcare Medicare Advantage |
$48,849.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$48,849.55
|
| Rate for Payer: Wellcare Medicare |
$46,407.07
|
|
|
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC
|
Facility
|
IP
|
$50,350.46
|
|
|
Service Code
|
MSDRG 522
|
| Min. Negotiated Rate |
$17,027.61 |
| Max. Negotiated Rate |
$50,350.46 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$31,144.39
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$36,618.52
|
| Rate for Payer: Aetna Government |
$36,618.52
|
| Rate for Payer: Brighton Health Commercial |
$30,626.90
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$37,350.89
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$36,475.58
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$30,101.22
|
| Rate for Payer: Elderplan Medicare Advantage |
$34,787.59
|
| Rate for Payer: EmblemHealth Commercial |
$18,112.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$36,618.52
|
| Rate for Payer: Group Health Inc Commercial |
$36,618.52
|
| Rate for Payer: Group Health Inc Medicare |
$36,618.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$36,618.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17,027.61
|
| Rate for Payer: Humana Medicare |
$50,350.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$36,618.52
|
| Rate for Payer: United Healthcare Commercial |
$42,005.32
|
| Rate for Payer: United Healthcare Medicare Advantage |
$36,618.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$36,618.52
|
| Rate for Payer: Wellcare Medicare |
$34,787.59
|
|
