|
Level Ii Clotting Tests
|
Facility
|
OP
|
$0.04
|
|
|
Service Code
|
EAPG 00407
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.04 |
| Rate for Payer: Sunshine Health Medicaid |
$0.04
|
|
|
Level Ii Complex Laboratory, Molecular Pathology And Genetic Tests
|
Facility
|
OP
|
$0.26
|
|
|
Service Code
|
EAPG 00386
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$0.26 |
| Rate for Payer: Sunshine Health Medicaid |
$0.26
|
|
|
Level Ii Computed Tomography
|
Facility
|
OP
|
$0.67
|
|
|
Service Code
|
EAPG 00300
|
| Min. Negotiated Rate |
$0.67 |
| Max. Negotiated Rate |
$0.67 |
| Rate for Payer: Sunshine Health Medicaid |
$0.67
|
|
|
Level Ii Conventional Radiology
|
Facility
|
OP
|
$0.24
|
|
|
Service Code
|
EAPG 00389
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$0.24 |
| Rate for Payer: Sunshine Health Medicaid |
$0.24
|
|
|
Level Ii Corneal And Other Anterior Surface Eye Procedures
|
Facility
|
OP
|
$6.87
|
|
|
Service Code
|
EAPG 00248
|
| Min. Negotiated Rate |
$6.87 |
| Max. Negotiated Rate |
$6.87 |
| Rate for Payer: Sunshine Health Medicaid |
$6.87
|
|
|
Level Ii Craniofacial Bone Procedures
|
Facility
|
OP
|
$11.08
|
|
|
Service Code
|
EAPG 00228
|
| Min. Negotiated Rate |
$11.08 |
| Max. Negotiated Rate |
$11.08 |
| Rate for Payer: Sunshine Health Medicaid |
$11.08
|
|
|
Level Ii Dental Imaging
|
Facility
|
OP
|
$0.30
|
|
|
Service Code
|
EAPG 00374
|
| Min. Negotiated Rate |
$0.30 |
| Max. Negotiated Rate |
$0.30 |
| Rate for Payer: Sunshine Health Medicaid |
$0.30
|
|
|
Level Ii Dental Implants
|
Facility
|
OP
|
$3.00
|
|
|
Service Code
|
EAPG 00382
|
| Min. Negotiated Rate |
$3.00 |
| Max. Negotiated Rate |
$3.00 |
| Rate for Payer: Sunshine Health Medicaid |
$3.00
|
|
|
Level Ii Dental Restorations
|
Facility
|
OP
|
$5.14
|
|
|
Service Code
|
EAPG 00362
|
| Min. Negotiated Rate |
$5.14 |
| Max. Negotiated Rate |
$5.14 |
| Rate for Payer: Sunshine Health Medicaid |
$5.14
|
|
|
Level Ii Diagnostic Nuclear Medicine
|
Facility
|
OP
|
$1.82
|
|
|
Service Code
|
EAPG 00332
|
| Min. Negotiated Rate |
$1.82 |
| Max. Negotiated Rate |
$1.82 |
| Rate for Payer: Sunshine Health Medicaid |
$1.82
|
|
|
Level Ii Diagnostic Ultrasound
|
Facility
|
OP
|
$0.34
|
|
|
Service Code
|
EAPG 00289
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$0.34 |
| Rate for Payer: Sunshine Health Medicaid |
$0.34
|
|
|
Level Ii Drug Screening And Definitive Tests
|
Facility
|
OP
|
$0.11
|
|
|
Service Code
|
EAPG 02041
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.11 |
| Rate for Payer: Sunshine Health Medicaid |
$0.11
|
|
|
Level Ii Ear, Nose, Mouth And Throat Procedures
|
Facility
|
OP
|
$5.58
|
|
|
Service Code
|
EAPG 00253
|
| Min. Negotiated Rate |
$5.58 |
| Max. Negotiated Rate |
$5.58 |
| Rate for Payer: Sunshine Health Medicaid |
$5.58
|
|
|
Level Ii Endocrinology Tests
|
Facility
|
OP
|
$0.06
|
|
|
Service Code
|
EAPG 00399
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.06 |
| Rate for Payer: Sunshine Health Medicaid |
$0.06
|
|
|
Level Ii Endodontics
|
Facility
|
OP
|
$0.53
|
|
|
Service Code
|
EAPG 00365
|
| Min. Negotiated Rate |
$0.53 |
| Max. Negotiated Rate |
$0.53 |
| Rate for Payer: Sunshine Health Medicaid |
$0.53
|
|
|
Level Ii Endoscopy Of The Upper Airway
|
Facility
|
OP
|
$4.08
|
|
|
Service Code
|
EAPG 00063
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$4.08 |
| Rate for Payer: Sunshine Health Medicaid |
$4.08
|
|
|
Level Ii Ercp And Related Endoscopic Procedures
|
Facility
|
OP
|
$9.29
|
|
|
Service Code
|
EAPG 00153
|
| Min. Negotiated Rate |
$9.29 |
| Max. Negotiated Rate |
$9.29 |
| Rate for Payer: Sunshine Health Medicaid |
$9.29
|
|
|
Level Ii Esophageal And Gastric Surgical Procedures
|
Facility
|
OP
|
$7.94
|
|
|
Service Code
|
EAPG 00126
|
| Min. Negotiated Rate |
$7.94 |
| Max. Negotiated Rate |
$7.94 |
| Rate for Payer: Sunshine Health Medicaid |
$7.94
|
|
|
Level Ii Eyelid, Lacrimal And Conjunctival Procedures
|
Facility
|
OP
|
$3.65
|
|
|
Service Code
|
EAPG 00259
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$3.65 |
| Rate for Payer: Sunshine Health Medicaid |
$3.65
|
|
|
Level Ii Fetal Procedures
|
Facility
|
OP
|
$2.10
|
|
|
Service Code
|
EAPG 00192
|
| Min. Negotiated Rate |
$2.10 |
| Max. Negotiated Rate |
$2.10 |
| Rate for Payer: Sunshine Health Medicaid |
$2.10
|
|
|
Level Ii Foot Procedures
|
Facility
|
OP
|
$12.34
|
|
|
Service Code
|
EAPG 00036
|
| Min. Negotiated Rate |
$12.34 |
| Max. Negotiated Rate |
$12.34 |
| Rate for Payer: Sunshine Health Medicaid |
$12.34
|
|
|
Level Ii Forearm And Wrist Procedures
|
Facility
|
OP
|
$11.92
|
|
|
Service Code
|
EAPG 00024
|
| Min. Negotiated Rate |
$11.92 |
| Max. Negotiated Rate |
$11.92 |
| Rate for Payer: Sunshine Health Medicaid |
$11.92
|
|
|
Level Ii Hand Procedures
|
Facility
|
OP
|
$4.53
|
|
|
Service Code
|
EAPG 00034
|
| Min. Negotiated Rate |
$4.53 |
| Max. Negotiated Rate |
$4.53 |
| Rate for Payer: Sunshine Health Medicaid |
$4.53
|
|
|
Level Ii Hepatobiliary And Pancreas Procedures
|
Facility
|
OP
|
$11.71
|
|
|
Service Code
|
EAPG 00152
|
| Min. Negotiated Rate |
$11.71 |
| Max. Negotiated Rate |
$11.71 |
| Rate for Payer: Sunshine Health Medicaid |
$11.71
|
|
|
Level Ii Hip And Femur Procedures
|
Facility
|
OP
|
$23.40
|
|
|
Service Code
|
EAPG 00055
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Sunshine Health Medicaid |
$23.40
|
|
