|
EAPG 390: LEVEL I PATHOLOGY TESTS
|
Facility
|
OP
|
$84.51
|
|
|
Service Code
|
EAPG 0390
|
| Min. Negotiated Rate |
$37.56 |
| Max. Negotiated Rate |
$84.51 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$84.51
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$37.56
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$37.56
|
| Rate for Payer: CDPHP Essential Plan |
$84.51
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$45.07
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$37.56
|
| Rate for Payer: EmblemHealth Medicaid |
$37.56
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$84.51
|
| Rate for Payer: Hamaspik Choice Medicaid |
$37.56
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$37.56
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$80.75
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$80.75
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$37.56
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$39.44
|
|
|
EAPG 391: LEVEL II PATHOLOGY TESTS
|
Facility
|
OP
|
$157.25
|
|
|
Service Code
|
EAPG 0391
|
| Min. Negotiated Rate |
$69.89 |
| Max. Negotiated Rate |
$157.25 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$157.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$69.89
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$69.89
|
| Rate for Payer: CDPHP Essential Plan |
$157.25
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$83.87
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$69.89
|
| Rate for Payer: EmblemHealth Medicaid |
$69.89
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$157.25
|
| Rate for Payer: Hamaspik Choice Medicaid |
$69.89
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$69.89
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$150.26
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$150.26
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$69.89
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$73.38
|
|
|
EAPG 392: PAP SMEARS
|
Facility
|
OP
|
$65.72
|
|
|
Service Code
|
EAPG 0392
|
| Min. Negotiated Rate |
$29.21 |
| Max. Negotiated Rate |
$65.72 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$65.72
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$29.21
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$29.21
|
| Rate for Payer: CDPHP Essential Plan |
$65.72
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$35.05
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$29.21
|
| Rate for Payer: EmblemHealth Medicaid |
$29.21
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$65.72
|
| Rate for Payer: Hamaspik Choice Medicaid |
$29.21
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$29.21
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$62.80
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$62.80
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$29.21
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$30.67
|
|
|
EAPG 393: LEVEL II BLOOD AND TISSUE TYPING TESTS
|
Facility
|
OP
|
$93.35
|
|
|
Service Code
|
EAPG 0393
|
| Min. Negotiated Rate |
$41.49 |
| Max. Negotiated Rate |
$93.35 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$93.35
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$41.49
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$41.49
|
| Rate for Payer: CDPHP Essential Plan |
$93.35
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$49.79
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$41.49
|
| Rate for Payer: EmblemHealth Medicaid |
$41.49
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$93.35
|
| Rate for Payer: Hamaspik Choice Medicaid |
$41.49
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$41.49
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$89.20
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$89.20
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$41.49
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$43.56
|
|
|
EAPG 394: LEVEL I IMMUNOLOGY TESTS
|
Facility
|
OP
|
$23.76
|
|
|
Service Code
|
EAPG 0394
|
| Min. Negotiated Rate |
$10.56 |
| Max. Negotiated Rate |
$23.76 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$23.76
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$10.56
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$10.56
|
| Rate for Payer: CDPHP Essential Plan |
$23.76
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$12.67
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$10.56
|
| Rate for Payer: EmblemHealth Medicaid |
$10.56
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$23.76
|
| Rate for Payer: Hamaspik Choice Medicaid |
$10.56
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$10.56
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$22.70
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$22.70
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$10.56
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$11.09
|
|
|
EAPG 395: LEVEL II IMMUNOLOGY TESTS
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
EAPG 0395
|
| Min. Negotiated Rate |
$37.78 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$85.00
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$37.78
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$37.78
|
| Rate for Payer: CDPHP Essential Plan |
$85.00
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$45.34
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$37.78
|
| Rate for Payer: EmblemHealth Medicaid |
$37.78
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$85.00
|
| Rate for Payer: Hamaspik Choice Medicaid |
$37.78
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$37.78
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$81.23
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$81.23
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$37.78
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$39.67
|
|
|
EAPG 396: LEVEL I MICROBIOLOGY TESTS
|
Facility
|
OP
|
$21.98
|
|
|
Service Code
|
EAPG 0396
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$21.98 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$21.98
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$9.77
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$9.77
|
| Rate for Payer: CDPHP Essential Plan |
$21.98
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$11.72
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$9.77
|
| Rate for Payer: EmblemHealth Medicaid |
$9.77
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$21.98
|
| Rate for Payer: Hamaspik Choice Medicaid |
$9.77
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$9.77
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$21.01
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$21.01
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$9.77
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$10.26
|
|
|
EAPG 397: LEVEL II MICROBIOLOGY TESTS
|
Facility
|
OP
|
$87.01
|
|
|
Service Code
|
EAPG 0397
|
| Min. Negotiated Rate |
$38.67 |
| Max. Negotiated Rate |
$87.01 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$87.01
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$38.67
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$38.67
|
| Rate for Payer: CDPHP Essential Plan |
$87.01
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$46.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$38.67
|
| Rate for Payer: EmblemHealth Medicaid |
$38.67
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$87.01
|
| Rate for Payer: Hamaspik Choice Medicaid |
$38.67
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$38.67
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$83.14
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$83.14
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$38.67
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$40.60
|
|
|
EAPG 398: LEVEL I ENDOCRINOLOGY TESTS
|
Facility
|
OP
|
$57.35
|
|
|
Service Code
|
EAPG 0398
|
| Min. Negotiated Rate |
$25.49 |
| Max. Negotiated Rate |
$57.35 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$57.35
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$25.49
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$25.49
|
| Rate for Payer: CDPHP Essential Plan |
$57.35
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$30.59
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$25.49
|
| Rate for Payer: EmblemHealth Medicaid |
$25.49
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$57.35
|
| Rate for Payer: Hamaspik Choice Medicaid |
$25.49
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$25.49
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$54.80
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$54.80
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$25.49
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$26.76
|
|
|
EAPG 399: LEVEL II ENDOCRINOLOGY TESTS
|
Facility
|
OP
|
$80.75
|
|
|
Service Code
|
EAPG 0399
|
| Min. Negotiated Rate |
$35.89 |
| Max. Negotiated Rate |
$80.75 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$80.75
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$35.89
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$35.89
|
| Rate for Payer: CDPHP Essential Plan |
$80.75
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$43.07
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$35.89
|
| Rate for Payer: EmblemHealth Medicaid |
$35.89
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$80.75
|
| Rate for Payer: Hamaspik Choice Medicaid |
$35.89
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$35.89
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$77.16
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$77.16
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$35.89
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$37.68
|
|
|
EAPG 39: CAST APPLICATION OR REPLACEMENT
|
Facility
|
OP
|
$578.32
|
|
|
Service Code
|
EAPG 0039
|
| Min. Negotiated Rate |
$257.03 |
| Max. Negotiated Rate |
$578.32 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$578.32
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$257.03
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$257.03
|
| Rate for Payer: CDPHP Essential Plan |
$578.32
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$308.44
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$257.03
|
| Rate for Payer: EmblemHealth Medicaid |
$257.03
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$578.32
|
| Rate for Payer: Hamaspik Choice Medicaid |
$257.03
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$257.03
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$552.61
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$552.61
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$257.03
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$269.88
|
|
|
EAPG 3: LEVEL I SKIN INCISION AND DRAINAGE, DEBRIDEMENT, DESTRUCTION, OTHER RELATED PX
|
Facility
|
OP
|
$642.28
|
|
|
Service Code
|
EAPG 0003
|
| Min. Negotiated Rate |
$285.46 |
| Max. Negotiated Rate |
$642.28 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$642.28
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$285.46
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$285.46
|
| Rate for Payer: CDPHP Essential Plan |
$642.28
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$342.55
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$285.46
|
| Rate for Payer: EmblemHealth Medicaid |
$285.46
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$642.28
|
| Rate for Payer: Hamaspik Choice Medicaid |
$285.46
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$285.46
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$613.74
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$613.74
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$285.46
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$299.73
|
|
|
EAPG 4001: EMERGING TECHNOLOGY PROCEDURES
|
Facility
|
OP
|
$166.16
|
|
|
Service Code
|
EAPG 4001
|
| Min. Negotiated Rate |
$73.85 |
| Max. Negotiated Rate |
$166.16 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$166.16
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$73.85
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$73.85
|
| Rate for Payer: CDPHP Essential Plan |
$166.16
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$88.62
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$73.85
|
| Rate for Payer: EmblemHealth Medicaid |
$73.85
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$166.16
|
| Rate for Payer: Galaxy Health Workers Comp |
$108.56
|
| Rate for Payer: Hamaspik Choice Medicaid |
$73.85
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$73.85
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$158.78
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$158.78
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$73.85
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$77.54
|
|
|
EAPG 400: LEVEL I CHEMISTRY TESTS
|
Facility
|
OP
|
$24.44
|
|
|
Service Code
|
EAPG 0400
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$24.44 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$24.44
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$10.86
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$10.86
|
| Rate for Payer: CDPHP Essential Plan |
$24.44
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$13.03
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$10.86
|
| Rate for Payer: EmblemHealth Medicaid |
$10.86
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$24.44
|
| Rate for Payer: Hamaspik Choice Medicaid |
$10.86
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$10.86
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$23.35
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$23.35
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$10.86
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$11.40
|
|
|
EAPG 401: LEVEL II CHEMISTRY TESTS
|
Facility
|
OP
|
$76.25
|
|
|
Service Code
|
EAPG 0401
|
| Min. Negotiated Rate |
$33.89 |
| Max. Negotiated Rate |
$76.25 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$76.25
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$33.89
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$33.89
|
| Rate for Payer: CDPHP Essential Plan |
$76.25
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$40.67
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$33.89
|
| Rate for Payer: EmblemHealth Medicaid |
$33.89
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$76.25
|
| Rate for Payer: Hamaspik Choice Medicaid |
$33.89
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$33.89
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$72.86
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$72.86
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$33.89
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$35.58
|
|
|
EAPG 402: BASIC CHEMISTRY TESTS
|
Facility
|
OP
|
$15.19
|
|
|
Service Code
|
EAPG 0402
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$15.19 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$15.19
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$6.75
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$6.75
|
| Rate for Payer: CDPHP Essential Plan |
$15.19
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$8.10
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$6.75
|
| Rate for Payer: EmblemHealth Medicaid |
$6.75
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$15.19
|
| Rate for Payer: Hamaspik Choice Medicaid |
$6.75
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$6.75
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$14.51
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$14.51
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$6.75
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$7.09
|
|
|
EAPG 403: ORGAN OR DISEASE ORIENTED PANELS
|
Facility
|
OP
|
$58.68
|
|
|
Service Code
|
EAPG 0403
|
| Min. Negotiated Rate |
$26.08 |
| Max. Negotiated Rate |
$58.68 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$58.68
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$26.08
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$26.08
|
| Rate for Payer: CDPHP Essential Plan |
$58.68
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$31.30
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$26.08
|
| Rate for Payer: EmblemHealth Medicaid |
$26.08
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$58.68
|
| Rate for Payer: Hamaspik Choice Medicaid |
$26.08
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$26.08
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$56.07
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$56.07
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$26.08
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$27.38
|
|
|
EAPG 404: TOXICOLOGY TESTS
|
Facility
|
OP
|
$42.98
|
|
|
Service Code
|
EAPG 0404
|
| Min. Negotiated Rate |
$19.10 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$42.98
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$19.10
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$19.10
|
| Rate for Payer: CDPHP Essential Plan |
$42.98
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$22.92
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$19.10
|
| Rate for Payer: EmblemHealth Medicaid |
$19.10
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$42.98
|
| Rate for Payer: Hamaspik Choice Medicaid |
$19.10
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$19.10
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$41.06
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$41.06
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$19.10
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$20.06
|
|
|
EAPG 405: THERAPEUTIC DRUG MONITORING
|
Facility
|
OP
|
$38.54
|
|
|
Service Code
|
EAPG 0405
|
| Min. Negotiated Rate |
$17.13 |
| Max. Negotiated Rate |
$38.54 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$38.54
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$17.13
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$17.13
|
| Rate for Payer: CDPHP Essential Plan |
$38.54
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$20.56
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$17.13
|
| Rate for Payer: EmblemHealth Medicaid |
$17.13
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$38.54
|
| Rate for Payer: Hamaspik Choice Medicaid |
$17.13
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$17.13
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$36.83
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$36.83
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$17.13
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$17.99
|
|
|
EAPG 406: LEVEL I CLOTTING TESTS
|
Facility
|
OP
|
$30.22
|
|
|
Service Code
|
EAPG 0406
|
| Min. Negotiated Rate |
$13.43 |
| Max. Negotiated Rate |
$30.22 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$30.22
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$13.43
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$13.43
|
| Rate for Payer: CDPHP Essential Plan |
$30.22
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$16.12
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$13.43
|
| Rate for Payer: EmblemHealth Medicaid |
$13.43
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$30.22
|
| Rate for Payer: Hamaspik Choice Medicaid |
$13.43
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$13.43
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$28.87
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$28.87
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$13.43
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$14.10
|
|
|
EAPG 407: LEVEL II CLOTTING TESTS
|
Facility
|
OP
|
$90.58
|
|
|
Service Code
|
EAPG 0407
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$90.58 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$90.58
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$40.26
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$40.26
|
| Rate for Payer: CDPHP Essential Plan |
$90.58
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$48.31
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$40.26
|
| Rate for Payer: EmblemHealth Medicaid |
$40.26
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$90.58
|
| Rate for Payer: Hamaspik Choice Medicaid |
$40.26
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$40.26
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$86.56
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$86.56
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$40.26
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$42.27
|
|
|
EAPG 408: LEVEL I HEMATOLOGY TESTS
|
Facility
|
OP
|
$25.13
|
|
|
Service Code
|
EAPG 0408
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$25.13 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$25.13
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$11.17
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$11.17
|
| Rate for Payer: CDPHP Essential Plan |
$25.13
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$13.40
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$11.17
|
| Rate for Payer: EmblemHealth Medicaid |
$11.17
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$25.13
|
| Rate for Payer: Hamaspik Choice Medicaid |
$11.17
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$11.17
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$24.02
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$24.02
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$11.17
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$11.73
|
|
|
EAPG 409: LEVEL II HEMATOLOGY TESTS
|
Facility
|
OP
|
$61.27
|
|
|
Service Code
|
EAPG 0409
|
| Min. Negotiated Rate |
$27.23 |
| Max. Negotiated Rate |
$61.27 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$61.27
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$27.23
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$27.23
|
| Rate for Payer: CDPHP Essential Plan |
$61.27
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$32.68
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$27.23
|
| Rate for Payer: EmblemHealth Medicaid |
$27.23
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$61.27
|
| Rate for Payer: Hamaspik Choice Medicaid |
$27.23
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$27.23
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$58.54
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$58.54
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$27.23
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$28.59
|
|
|
EAPG 40: MINOR SPLINT AND STRAPPING APPLICATION
|
Facility
|
OP
|
$423.14
|
|
|
Service Code
|
EAPG 0040
|
| Min. Negotiated Rate |
$188.06 |
| Max. Negotiated Rate |
$423.14 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$423.14
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$188.06
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$188.06
|
| Rate for Payer: CDPHP Essential Plan |
$423.14
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$225.67
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$188.06
|
| Rate for Payer: EmblemHealth Medicaid |
$188.06
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$423.14
|
| Rate for Payer: Hamaspik Choice Medicaid |
$188.06
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$188.06
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$404.33
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$404.33
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$188.06
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$197.46
|
|
|
EAPG 410: URINALYSIS
|
Facility
|
OP
|
$23.94
|
|
|
Service Code
|
EAPG 0410
|
| Min. Negotiated Rate |
$10.64 |
| Max. Negotiated Rate |
$23.94 |
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Essential Plan |
$23.94
|
| Rate for Payer: Blue Cross Blue Shield of New York (Empire) Medicaid |
$10.64
|
| Rate for Payer: CDPHP Child Health Plus/HARP/Select Plan |
$10.64
|
| Rate for Payer: CDPHP Essential Plan |
$23.94
|
| Rate for Payer: EmblemHealth Essential Plan 1/Essential Plan 2 |
$12.77
|
| Rate for Payer: EmblemHealth Essential Plan 3/Essential Plan 4 |
$10.64
|
| Rate for Payer: EmblemHealth Medicaid |
$10.64
|
| Rate for Payer: Fidelis Child Health Plus/Essential Plan/HARP/Medicaid |
$23.94
|
| Rate for Payer: Hamaspik Choice Medicaid |
$10.64
|
| Rate for Payer: MVP Health Care of NY Child Health Plus/Family Health Plus/HARP/Medicaid |
$10.64
|
| Rate for Payer: MVP Health Care of NY Essential Plan 1&2 |
$22.88
|
| Rate for Payer: MVP Health Care of NY Essential Plan 3&4 |
$22.88
|
| Rate for Payer: United Healthcare CHIP/Family Health Plus/Medicaid |
$10.64
|
| Rate for Payer: WellCare Child Health Plus/Family Health Plus/Medicaid |
$11.17
|
|
