|
Level Ii Hysterectomy And Myomectomy Procedures
|
Facility
|
OP
|
$12.35
|
|
|
Service Code
|
EAPG 00206
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$12.35 |
| Rate for Payer: Sunshine Health Medicaid |
$12.35
|
|
|
Level Iii Bladder And Ureteral Procedures
|
Facility
|
OP
|
$10.31
|
|
|
Service Code
|
EAPG 00175
|
| Min. Negotiated Rate |
$10.31 |
| Max. Negotiated Rate |
$10.31 |
| Rate for Payer: Sunshine Health Medicaid |
$10.31
|
|
|
Level Iii Blood And Tissue Typing Tests
|
Facility
|
OP
|
$0.28
|
|
|
Service Code
|
EAPG 02043
|
| Min. Negotiated Rate |
$0.28 |
| Max. Negotiated Rate |
$0.28 |
| Rate for Payer: Sunshine Health Medicaid |
$0.28
|
|
|
Level Iii Blood Product Exchange Services
|
Facility
|
OP
|
$9.04
|
|
|
Service Code
|
EAPG 00155
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$9.04 |
| Rate for Payer: Sunshine Health Medicaid |
$9.04
|
|
|
Level Iii Chemistry Tests
|
Facility
|
OP
|
$0.11
|
|
|
Service Code
|
EAPG 00384
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.11 |
| Rate for Payer: Sunshine Health Medicaid |
$0.11
|
|
|
Level Iii Complex Laboratory, Molecular Pathology And Genetic Tests
|
Facility
|
OP
|
$0.58
|
|
|
Service Code
|
EAPG 00387
|
| Min. Negotiated Rate |
$0.58 |
| Max. Negotiated Rate |
$0.58 |
| Rate for Payer: Sunshine Health Medicaid |
$0.58
|
|
|
Level Iii Dental Restorations
|
Facility
|
OP
|
$5.76
|
|
|
Service Code
|
EAPG 00363
|
| Min. Negotiated Rate |
$5.76 |
| Max. Negotiated Rate |
$5.76 |
| Rate for Payer: Sunshine Health Medicaid |
$5.76
|
|
|
Level Iii Drug Screening And Definitive Tests
|
Facility
|
OP
|
$0.26
|
|
|
Service Code
|
EAPG 02042
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$0.26 |
| Rate for Payer: Sunshine Health Medicaid |
$0.26
|
|
|
Level Iii Ear, Nose, Mouth And Throat Procedures
|
Facility
|
OP
|
$7.28
|
|
|
Service Code
|
EAPG 00254
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$7.28 |
| Rate for Payer: Sunshine Health Medicaid |
$7.28
|
|
|
Level Iii Endodontics
|
Facility
|
OP
|
$0.63
|
|
|
Service Code
|
EAPG 00366
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$0.63 |
| Rate for Payer: Sunshine Health Medicaid |
$0.63
|
|
|
Level Iii Kidney And Ureteral Procedures
|
Facility
|
OP
|
$14.80
|
|
|
Service Code
|
EAPG 00172
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$14.80 |
| Rate for Payer: Sunshine Health Medicaid |
$14.80
|
|
|
Level Iii Microbiology Tests
|
Facility
|
OP
|
$0.32
|
|
|
Service Code
|
EAPG 00388
|
| Min. Negotiated Rate |
$0.32 |
| Max. Negotiated Rate |
$0.32 |
| Rate for Payer: Sunshine Health Medicaid |
$0.32
|
|
|
Level Ii Immunization
|
Facility
|
OP
|
$0.27
|
|
|
Service Code
|
EAPG 00415
|
| Min. Negotiated Rate |
$0.27 |
| Max. Negotiated Rate |
$0.27 |
| Rate for Payer: Sunshine Health Medicaid |
$0.27
|
|
|
Level Ii Immunology Tests
|
Facility
|
OP
|
$0.07
|
|
|
Service Code
|
EAPG 00395
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.07 |
| Rate for Payer: Sunshine Health Medicaid |
$0.07
|
|
|
Level Ii Intravitreal, Retinal And Other Posterior Chamber Eye Procedures
|
Facility
|
OP
|
$6.69
|
|
|
Service Code
|
EAPG 00238
|
| Min. Negotiated Rate |
$6.69 |
| Max. Negotiated Rate |
$6.69 |
| Rate for Payer: Sunshine Health Medicaid |
$6.69
|
|
|
Level Iii Oral Surgery Procedures
|
Facility
|
OP
|
$6.59
|
|
|
Service Code
|
EAPG 00369
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$6.59 |
| Rate for Payer: Sunshine Health Medicaid |
$6.59
|
|
|
Level Iii Pathology Tests
|
Facility
|
OP
|
$0.35
|
|
|
Service Code
|
EAPG 00308
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$0.35 |
| Rate for Payer: Sunshine Health Medicaid |
$0.35
|
|
|
Level Iii Peripheral Endovascular And Transcatheter Procedures
|
Facility
|
OP
|
$22.71
|
|
|
Service Code
|
EAPG 00085
|
| Min. Negotiated Rate |
$22.71 |
| Max. Negotiated Rate |
$22.71 |
| Rate for Payer: Sunshine Health Medicaid |
$22.71
|
|
|
Level Iii Prosthodontics, Fixed
|
Facility
|
OP
|
$1.00
|
|
|
Service Code
|
EAPG 00355
|
| Min. Negotiated Rate |
$1.00 |
| Max. Negotiated Rate |
$1.00 |
| Rate for Payer: Sunshine Health Medicaid |
$1.00
|
|
|
Level Iii Prosthodontics, Removable
|
Facility
|
OP
|
$0.64
|
|
|
Service Code
|
EAPG 00358
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$0.64 |
| Rate for Payer: Sunshine Health Medicaid |
$0.64
|
|
|
Level Iii Radiation Therapy
|
Facility
|
OP
|
$2.84
|
|
|
Service Code
|
EAPG 00348
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$2.84 |
| Rate for Payer: Sunshine Health Medicaid |
$2.84
|
|
|
Level Iii Radiation Treatment Preparation And Planning
|
Facility
|
OP
|
$2.17
|
|
|
Service Code
|
EAPG 00478
|
| Min. Negotiated Rate |
$2.17 |
| Max. Negotiated Rate |
$2.17 |
| Rate for Payer: Sunshine Health Medicaid |
$2.17
|
|
|
Level Iii Skin Excisions, Biopsies, And Repairs
|
Facility
|
OP
|
$3.80
|
|
|
Service Code
|
EAPG 00011
|
| Min. Negotiated Rate |
$3.80 |
| Max. Negotiated Rate |
$3.80 |
| Rate for Payer: Sunshine Health Medicaid |
$3.80
|
|
|
Level Iii Spine Procedures
|
Facility
|
OP
|
$33.39
|
|
|
Service Code
|
EAPG 00057
|
| Min. Negotiated Rate |
$33.39 |
| Max. Negotiated Rate |
$33.39 |
| Rate for Payer: Sunshine Health Medicaid |
$33.39
|
|
|
Level Iii Upper Gi Endoscopy
|
Facility
|
OP
|
$8.52
|
|
|
Service Code
|
EAPG 00154
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$8.52 |
| Rate for Payer: Sunshine Health Medicaid |
$8.52
|
|
