|
Level Ii Peripheral Vascular Repair, Ligation Or Reconstruction
|
Facility
|
OP
|
$8.05
|
|
|
Service Code
|
EAPG 00091
|
| Min. Negotiated Rate |
$8.05 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Sunshine Health Medicaid |
$8.05
|
|
|
Level Ii Prostate Procedures
|
Facility
|
OP
|
$9.87
|
|
|
Service Code
|
EAPG 00184
|
| Min. Negotiated Rate |
$9.87 |
| Max. Negotiated Rate |
$9.87 |
| Rate for Payer: Sunshine Health Medicaid |
$9.87
|
|
|
Level Ii Prosthodontics, Fixed
|
Facility
|
OP
|
$0.81
|
|
|
Service Code
|
EAPG 00354
|
| Min. Negotiated Rate |
$0.81 |
| Max. Negotiated Rate |
$0.81 |
| Rate for Payer: Sunshine Health Medicaid |
$0.81
|
|
|
Level Ii Prosthodontics, Removable
|
Facility
|
OP
|
$0.54
|
|
|
Service Code
|
EAPG 00357
|
| Min. Negotiated Rate |
$0.54 |
| Max. Negotiated Rate |
$0.54 |
| Rate for Payer: Sunshine Health Medicaid |
$0.54
|
|
|
Level Ii Radiation Therapy
|
Facility
|
OP
|
$0.96
|
|
|
Service Code
|
EAPG 00347
|
| Min. Negotiated Rate |
$0.96 |
| Max. Negotiated Rate |
$0.96 |
| Rate for Payer: Sunshine Health Medicaid |
$0.96
|
|
|
Level Ii Radiation Treatment Preparation And Planning
|
Facility
|
OP
|
$0.38
|
|
|
Service Code
|
EAPG 00477
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$0.38 |
| Rate for Payer: Sunshine Health Medicaid |
$0.38
|
|
|
Level Ii Shoulder And Upper Arm Procedures
|
Facility
|
OP
|
$20.24
|
|
|
Service Code
|
EAPG 00058
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$20.24 |
| Rate for Payer: Sunshine Health Medicaid |
$20.24
|
|
|
Level Ii Skin Excisions, Biopsies, And Repairs
|
Facility
|
OP
|
$2.53
|
|
|
Service Code
|
EAPG 00010
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$2.53 |
| Rate for Payer: Sunshine Health Medicaid |
$2.53
|
|
|
Level Ii Skin Incision And Drainage, Debridement, Destruction, Other Related Px
|
Facility
|
OP
|
$2.33
|
|
|
Service Code
|
EAPG 00004
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$2.33 |
| Rate for Payer: Sunshine Health Medicaid |
$2.33
|
|
|
Level Ii Small And Large Intestine Surgical Procedures
|
Facility
|
OP
|
$8.47
|
|
|
Service Code
|
EAPG 00128
|
| Min. Negotiated Rate |
$8.47 |
| Max. Negotiated Rate |
$8.47 |
| Rate for Payer: Sunshine Health Medicaid |
$8.47
|
|
|
Level Ii Spine Procedures
|
Facility
|
OP
|
$20.98
|
|
|
Service Code
|
EAPG 00029
|
| Min. Negotiated Rate |
$20.98 |
| Max. Negotiated Rate |
$20.98 |
| Rate for Payer: Sunshine Health Medicaid |
$20.98
|
|
|
Level Ii Surgical Pathology Tests
|
Facility
|
OP
|
$0.32
|
|
|
Service Code
|
EAPG 00306
|
| Min. Negotiated Rate |
$0.32 |
| Max. Negotiated Rate |
$0.32 |
| Rate for Payer: Sunshine Health Medicaid |
$0.32
|
|
|
Level Ii Thoracic And Chest Procedures
|
Facility
|
OP
|
$11.26
|
|
|
Service Code
|
EAPG 00070
|
| Min. Negotiated Rate |
$11.26 |
| Max. Negotiated Rate |
$11.26 |
| Rate for Payer: Sunshine Health Medicaid |
$11.26
|
|
|
Level Ii Upper Gi Endoscopy
|
Facility
|
OP
|
$4.55
|
|
|
Service Code
|
EAPG 00135
|
| Min. Negotiated Rate |
$4.55 |
| Max. Negotiated Rate |
$4.55 |
| Rate for Payer: Sunshine Health Medicaid |
$4.55
|
|
|
Level Ii Urethral Procedures
|
Facility
|
OP
|
$12.52
|
|
|
Service Code
|
EAPG 00167
|
| Min. Negotiated Rate |
$12.52 |
| Max. Negotiated Rate |
$12.52 |
| Rate for Payer: Sunshine Health Medicaid |
$12.52
|
|
|
Level Ii Varicose Vein And Related Procedures
|
Facility
|
OP
|
$5.41
|
|
|
Service Code
|
EAPG 00103
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$5.41 |
| Rate for Payer: Sunshine Health Medicaid |
$5.41
|
|
|
Level Ii Vascular Radiological Procedures
|
Facility
|
OP
|
$3.56
|
|
|
Service Code
|
EAPG 00279
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$3.56 |
| Rate for Payer: Sunshine Health Medicaid |
$3.56
|
|
|
Level I Joint, Tendon, Or Ligament Injection Procedures
|
Facility
|
OP
|
$0.52
|
|
|
Service Code
|
EAPG 00049
|
| Min. Negotiated Rate |
$0.52 |
| Max. Negotiated Rate |
$0.52 |
| Rate for Payer: Sunshine Health Medicaid |
$0.52
|
|
|
Level I Kidney And Ureteral Procedures
|
Facility
|
OP
|
$3.14
|
|
|
Service Code
|
EAPG 00170
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$3.14 |
| Rate for Payer: Sunshine Health Medicaid |
$3.14
|
|
|
Level I Knee And Lower Leg Procedures
|
Facility
|
OP
|
$6.80
|
|
|
Service Code
|
EAPG 00026
|
| Min. Negotiated Rate |
$6.80 |
| Max. Negotiated Rate |
$6.80 |
| Rate for Payer: Sunshine Health Medicaid |
$6.80
|
|
|
Level I Lower Airway Endoscopy
|
Facility
|
OP
|
$3.94
|
|
|
Service Code
|
EAPG 00064
|
| Min. Negotiated Rate |
$3.94 |
| Max. Negotiated Rate |
$3.94 |
| Rate for Payer: Sunshine Health Medicaid |
$3.94
|
|
|
Level I Lower Gi Endoscopy
|
Facility
|
OP
|
$2.07
|
|
|
Service Code
|
EAPG 00136
|
| Min. Negotiated Rate |
$2.07 |
| Max. Negotiated Rate |
$2.07 |
| Rate for Payer: Sunshine Health Medicaid |
$2.07
|
|
|
Level I Mastectomy And Reconstructive Breast Procedures
|
Facility
|
OP
|
$7.28
|
|
|
Service Code
|
EAPG 00021
|
| Min. Negotiated Rate |
$7.28 |
| Max. Negotiated Rate |
$7.28 |
| Rate for Payer: Sunshine Health Medicaid |
$7.28
|
|
|
Level I Maxillofacial Prosthetics
|
Facility
|
OP
|
$3.78
|
|
|
Service Code
|
EAPG 00359
|
| Min. Negotiated Rate |
$3.78 |
| Max. Negotiated Rate |
$3.78 |
| Rate for Payer: Sunshine Health Medicaid |
$3.78
|
|
|
Level I Microbiology Tests
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
EAPG 00396
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Sunshine Health Medicaid |
$0.01
|
|
