|
PR EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT
|
Professional
|
Both
|
$2,579.33
|
|
|
Service Code
|
HCPCS 60281
|
| Min. Negotiated Rate |
$484.90 |
| Max. Negotiated Rate |
$1,558.60 |
| Rate for Payer: Cash Price |
$699.26
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$692.71
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$623.44
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$623.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$658.07
|
| Rate for Payer: Fidelis Medicare Advantage |
$692.71
|
| Rate for Payer: Fidelis Qualified Health Plan |
$658.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$692.71
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$692.71
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$519.53
|
| Rate for Payer: Healthfirst Commercial |
$692.71
|
| Rate for Payer: Healthfirst Essential Plan |
$1,558.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$658.07
|
| Rate for Payer: Healthfirst QHP |
$692.71
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$484.90
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$692.71
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$588.80
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$484.90
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$692.71
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$519.53
|
| Rate for Payer: SOMOS Essential |
$519.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$692.71
|
|
|
PR EXCISION TONSIL TAGS
|
Professional
|
Both
|
$843.99
|
|
|
Service Code
|
HCPCS 42860
|
| Min. Negotiated Rate |
$160.38 |
| Max. Negotiated Rate |
$515.52 |
| Rate for Payer: Cash Price |
$230.76
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$229.12
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$206.21
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$206.21
|
| Rate for Payer: Fidelis Essential Plan QHP |
$217.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$229.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$217.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$229.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$229.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$171.84
|
| Rate for Payer: Healthfirst Commercial |
$229.12
|
| Rate for Payer: Healthfirst Essential Plan |
$515.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$217.66
|
| Rate for Payer: Healthfirst QHP |
$229.12
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$160.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$229.12
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$194.75
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$160.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$229.12
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$171.84
|
| Rate for Payer: SOMOS Essential |
$171.84
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$229.12
|
|
|
PR EXCISION TORUS MANDIBULARIS
|
Professional
|
Both
|
$1,151.78
|
|
|
Service Code
|
HCPCS 21031
|
| Min. Negotiated Rate |
$220.09 |
| Max. Negotiated Rate |
$707.45 |
| Rate for Payer: Cash Price |
$315.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$314.42
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$282.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$282.98
|
| Rate for Payer: Fidelis Essential Plan QHP |
$298.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$314.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$298.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$314.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$314.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$235.81
|
| Rate for Payer: Healthfirst Commercial |
$314.42
|
| Rate for Payer: Healthfirst Essential Plan |
$707.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$298.70
|
| Rate for Payer: Healthfirst QHP |
$314.42
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$220.09
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$314.42
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$267.26
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$220.09
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$314.42
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$235.81
|
| Rate for Payer: SOMOS Essential |
$235.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$314.42
|
|
|
PR EXCISION TRACHEAL STENOSIS&ANASTOMOSIS CERVICA
|
Professional
|
Both
|
$5,156.76
|
|
|
Service Code
|
HCPCS 31780
|
| Min. Negotiated Rate |
$966.43 |
| Max. Negotiated Rate |
$3,106.39 |
| Rate for Payer: Cash Price |
$1,393.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,380.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,242.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,242.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,311.59
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,380.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,311.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,380.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,380.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,035.46
|
| Rate for Payer: Healthfirst Commercial |
$1,380.62
|
| Rate for Payer: Healthfirst Essential Plan |
$3,106.39
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,311.59
|
| Rate for Payer: Healthfirst QHP |
$1,380.62
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$966.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,380.62
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,173.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$966.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,380.62
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,035.46
|
| Rate for Payer: SOMOS Essential |
$1,035.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,380.62
|
|
|
PR EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL
|
Professional
|
Both
|
$4,619.41
|
|
|
Service Code
|
HCPCS 31785
|
| Min. Negotiated Rate |
$864.20 |
| Max. Negotiated Rate |
$2,777.78 |
| Rate for Payer: Cash Price |
$1,247.30
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,234.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,111.11
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,111.11
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,172.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,234.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,172.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,234.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,234.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$925.93
|
| Rate for Payer: Healthfirst Commercial |
$1,234.57
|
| Rate for Payer: Healthfirst Essential Plan |
$2,777.78
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,172.84
|
| Rate for Payer: Healthfirst QHP |
$1,234.57
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$864.20
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,234.57
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,049.38
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$864.20
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,234.57
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$925.93
|
| Rate for Payer: SOMOS Essential |
$925.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,234.57
|
|
|
PR EXCISION TRACHEAL TUMOR/CARCINOMA THORACIC
|
Professional
|
Both
|
$6,419.60
|
|
|
Service Code
|
HCPCS 31786
|
| Min. Negotiated Rate |
$1,184.43 |
| Max. Negotiated Rate |
$3,807.09 |
| Rate for Payer: Cash Price |
$1,708.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,692.04
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,522.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,522.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,607.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,692.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,607.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,692.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,692.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,269.03
|
| Rate for Payer: Healthfirst Commercial |
$1,692.04
|
| Rate for Payer: Healthfirst Essential Plan |
$3,807.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,607.44
|
| Rate for Payer: Healthfirst QHP |
$1,692.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,184.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,692.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,438.23
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,184.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,692.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,269.03
|
| Rate for Payer: SOMOS Essential |
$1,269.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,692.04
|
|
|
PR EXCISION/TRANSPOSITION PTERYGIUM W/GRAFG
|
Professional
|
Both
|
$1,966.34
|
|
|
Service Code
|
HCPCS 65426
|
| Min. Negotiated Rate |
$377.40 |
| Max. Negotiated Rate |
$1,213.07 |
| Rate for Payer: Cash Price |
$543.73
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$539.14
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$485.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$485.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$512.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$539.14
|
| Rate for Payer: Fidelis Qualified Health Plan |
$512.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$539.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$539.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$404.36
|
| Rate for Payer: Healthfirst Commercial |
$539.14
|
| Rate for Payer: Healthfirst Essential Plan |
$1,213.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$512.18
|
| Rate for Payer: Healthfirst QHP |
$539.14
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$377.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$539.14
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$458.27
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$377.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$539.14
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$404.36
|
| Rate for Payer: SOMOS Essential |
$404.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$539.14
|
|
|
PR EXCISION/TRANSPOSITION PTERYGIUM W/O GRAFT
|
Professional
|
Both
|
$1,572.06
|
|
|
Service Code
|
HCPCS 65420
|
| Min. Negotiated Rate |
$300.54 |
| Max. Negotiated Rate |
$966.01 |
| Rate for Payer: Cash Price |
$434.62
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$429.34
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$386.41
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$386.41
|
| Rate for Payer: Fidelis Essential Plan QHP |
$407.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$429.34
|
| Rate for Payer: Fidelis Qualified Health Plan |
$407.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$429.34
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$429.34
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$322.00
|
| Rate for Payer: Healthfirst Commercial |
$429.34
|
| Rate for Payer: Healthfirst Essential Plan |
$966.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$407.87
|
| Rate for Payer: Healthfirst QHP |
$429.34
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$300.54
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$429.34
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$364.94
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$300.54
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$429.34
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$322.00
|
| Rate for Payer: SOMOS Essential |
$322.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$429.34
|
|
|
PR EXCISION TROCHANTERIC BURSA/CALCIFICATION
|
Professional
|
Both
|
$2,019.82
|
|
|
Service Code
|
HCPCS 27062
|
| Min. Negotiated Rate |
$380.46 |
| Max. Negotiated Rate |
$1,222.92 |
| Rate for Payer: Cash Price |
$547.76
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$543.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$489.17
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$489.17
|
| Rate for Payer: Fidelis Essential Plan QHP |
$516.34
|
| Rate for Payer: Fidelis Medicare Advantage |
$543.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$516.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$543.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$543.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$407.64
|
| Rate for Payer: Healthfirst Commercial |
$543.52
|
| Rate for Payer: Healthfirst Essential Plan |
$1,222.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$516.34
|
| Rate for Payer: Healthfirst QHP |
$543.52
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$380.46
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$543.52
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$461.99
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$380.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$543.52
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$407.64
|
| Rate for Payer: SOMOS Essential |
$407.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$543.52
|
|
|
PR EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>
|
Professional
|
Both
|
$2,108.82
|
|
|
Service Code
|
HCPCS 21931
|
| Min. Negotiated Rate |
$395.82 |
| Max. Negotiated Rate |
$1,272.29 |
| Rate for Payer: Cash Price |
$567.30
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$565.46
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$508.91
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$508.91
|
| Rate for Payer: Fidelis Essential Plan QHP |
$537.19
|
| Rate for Payer: Fidelis Medicare Advantage |
$565.46
|
| Rate for Payer: Fidelis Qualified Health Plan |
$537.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$565.46
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$565.46
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$424.10
|
| Rate for Payer: Healthfirst Commercial |
$565.46
|
| Rate for Payer: Healthfirst Essential Plan |
$1,272.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$537.19
|
| Rate for Payer: Healthfirst QHP |
$565.46
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$395.82
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$565.46
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$480.64
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$395.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$565.46
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$424.10
|
| Rate for Payer: SOMOS Essential |
$424.10
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$565.46
|
|
|
PR EXCISION TUMOR SOFT TIS FOOT/TOE SUBQ 1.5 CM/>
|
Professional
|
Both
|
$1,448.93
|
|
|
Service Code
|
HCPCS 28039
|
| Min. Negotiated Rate |
$270.89 |
| Max. Negotiated Rate |
$870.73 |
| Rate for Payer: Cash Price |
$392.21
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$386.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$348.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$348.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$367.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$386.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$367.64
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$386.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$386.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$290.24
|
| Rate for Payer: Healthfirst Commercial |
$386.99
|
| Rate for Payer: Healthfirst Essential Plan |
$870.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$367.64
|
| Rate for Payer: Healthfirst QHP |
$386.99
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$270.89
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$386.99
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$328.94
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$270.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$386.99
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$290.24
|
| Rate for Payer: SOMOS Essential |
$290.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$386.99
|
|
|
PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>
|
Professional
|
Both
|
$1,500.80
|
|
|
Service Code
|
HCPCS 21012
|
| Min. Negotiated Rate |
$282.49 |
| Max. Negotiated Rate |
$908.01 |
| Rate for Payer: Cash Price |
$405.84
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$403.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$363.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$363.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$383.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$403.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$383.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$403.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$403.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$302.67
|
| Rate for Payer: Healthfirst Commercial |
$403.56
|
| Rate for Payer: Healthfirst Essential Plan |
$908.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$383.38
|
| Rate for Payer: Healthfirst QHP |
$403.56
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$282.49
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$403.56
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$343.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$282.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$403.56
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$302.67
|
| Rate for Payer: SOMOS Essential |
$302.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$403.56
|
|
|
PR EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM
|
Professional
|
Both
|
$1,133.58
|
|
|
Service Code
|
HCPCS 21011
|
| Min. Negotiated Rate |
$217.31 |
| Max. Negotiated Rate |
$698.49 |
| Rate for Payer: Cash Price |
$309.46
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$310.44
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$279.40
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$279.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$294.92
|
| Rate for Payer: Fidelis Medicare Advantage |
$310.44
|
| Rate for Payer: Fidelis Qualified Health Plan |
$294.92
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$310.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$310.44
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$232.83
|
| Rate for Payer: Healthfirst Commercial |
$310.44
|
| Rate for Payer: Healthfirst Essential Plan |
$698.49
|
| Rate for Payer: Healthfirst Medicare Advantage |
$294.92
|
| Rate for Payer: Healthfirst QHP |
$310.44
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$217.31
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$310.44
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$263.87
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$217.31
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$310.44
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$232.83
|
| Rate for Payer: SOMOS Essential |
$232.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$310.44
|
|
|
PR EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM
|
Professional
|
Both
|
$1,621.76
|
|
|
Service Code
|
HCPCS 21930
|
| Min. Negotiated Rate |
$304.87 |
| Max. Negotiated Rate |
$979.94 |
| Rate for Payer: Cash Price |
$439.46
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$435.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$391.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$391.98
|
| Rate for Payer: Fidelis Essential Plan QHP |
$413.75
|
| Rate for Payer: Fidelis Medicare Advantage |
$435.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$413.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$435.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$435.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$326.65
|
| Rate for Payer: Healthfirst Commercial |
$435.53
|
| Rate for Payer: Healthfirst Essential Plan |
$979.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$413.75
|
| Rate for Payer: Healthfirst QHP |
$435.53
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$304.87
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$435.53
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$370.20
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$304.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$435.53
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$326.65
|
| Rate for Payer: SOMOS Essential |
$326.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$435.53
|
|
|
PR EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM
|
Professional
|
Both
|
$1,091.72
|
|
|
Service Code
|
HCPCS 28043
|
| Min. Negotiated Rate |
$210.18 |
| Max. Negotiated Rate |
$675.59 |
| Rate for Payer: Cash Price |
$302.38
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$300.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$270.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$270.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$285.25
|
| Rate for Payer: Fidelis Medicare Advantage |
$300.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$285.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$300.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$300.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$225.19
|
| Rate for Payer: Healthfirst Commercial |
$300.26
|
| Rate for Payer: Healthfirst Essential Plan |
$675.59
|
| Rate for Payer: Healthfirst Medicare Advantage |
$285.25
|
| Rate for Payer: Healthfirst QHP |
$300.26
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$210.18
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$300.26
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$255.22
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$210.18
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$300.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$225.19
|
| Rate for Payer: SOMOS Essential |
$225.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$300.26
|
|
|
PR EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>
|
Professional
|
Both
|
$1,824.13
|
|
|
Service Code
|
HCPCS 27632
|
| Min. Negotiated Rate |
$341.92 |
| Max. Negotiated Rate |
$1,099.01 |
| Rate for Payer: Cash Price |
$489.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$488.45
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$439.61
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$439.61
|
| Rate for Payer: Fidelis Essential Plan QHP |
$464.03
|
| Rate for Payer: Fidelis Medicare Advantage |
$488.45
|
| Rate for Payer: Fidelis Qualified Health Plan |
$464.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$488.45
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$488.45
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$366.34
|
| Rate for Payer: Healthfirst Commercial |
$488.45
|
| Rate for Payer: Healthfirst Essential Plan |
$1,099.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$464.03
|
| Rate for Payer: Healthfirst QHP |
$488.45
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$341.92
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$488.45
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$415.18
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$341.92
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$488.45
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$366.34
|
| Rate for Payer: SOMOS Essential |
$366.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$488.45
|
|
|
PR EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3CM/>
|
Professional
|
Both
|
$2,108.82
|
|
|
Service Code
|
HCPCS 27043
|
| Min. Negotiated Rate |
$395.00 |
| Max. Negotiated Rate |
$1,269.65 |
| Rate for Payer: Cash Price |
$567.14
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$564.29
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$507.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$507.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$536.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$564.29
|
| Rate for Payer: Fidelis Qualified Health Plan |
$536.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$564.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$564.29
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$423.22
|
| Rate for Payer: Healthfirst Commercial |
$564.29
|
| Rate for Payer: Healthfirst Essential Plan |
$1,269.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$536.08
|
| Rate for Payer: Healthfirst QHP |
$564.29
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$395.00
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$564.29
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$479.65
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$395.00
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$564.29
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$423.22
|
| Rate for Payer: SOMOS Essential |
$423.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$564.29
|
|
|
PR EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>
|
Professional
|
Both
|
$1,878.94
|
|
|
Service Code
|
HCPCS 23071
|
| Min. Negotiated Rate |
$353.95 |
| Max. Negotiated Rate |
$1,137.71 |
| Rate for Payer: Cash Price |
$507.38
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$505.65
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$455.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$455.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$480.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$505.65
|
| Rate for Payer: Fidelis Qualified Health Plan |
$480.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$505.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$505.65
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$379.24
|
| Rate for Payer: Healthfirst Commercial |
$505.65
|
| Rate for Payer: Healthfirst Essential Plan |
$1,137.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$480.37
|
| Rate for Payer: Healthfirst QHP |
$505.65
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$353.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$505.65
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$429.80
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$353.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$505.65
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$379.24
|
| Rate for Payer: SOMOS Essential |
$379.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$505.65
|
|
|
PR EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM
|
Professional
|
Both
|
$1,458.07
|
|
|
Service Code
|
HCPCS 23075
|
| Min. Negotiated Rate |
$276.16 |
| Max. Negotiated Rate |
$887.65 |
| Rate for Payer: Cash Price |
$397.08
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$394.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$355.06
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$355.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$374.78
|
| Rate for Payer: Fidelis Medicare Advantage |
$394.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$374.78
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$394.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$394.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$295.88
|
| Rate for Payer: Healthfirst Commercial |
$394.51
|
| Rate for Payer: Healthfirst Essential Plan |
$887.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$374.78
|
| Rate for Payer: Healthfirst QHP |
$394.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$276.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$394.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$335.33
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$276.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$394.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$295.88
|
| Rate for Payer: SOMOS Essential |
$295.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$394.51
|
|
|
PR EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM
|
Professional
|
Both
|
$1,398.71
|
|
|
Service Code
|
HCPCS 27327
|
| Min. Negotiated Rate |
$264.32 |
| Max. Negotiated Rate |
$849.60 |
| Rate for Payer: Cash Price |
$380.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$377.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$339.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$339.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$358.72
|
| Rate for Payer: Fidelis Medicare Advantage |
$377.60
|
| Rate for Payer: Fidelis Qualified Health Plan |
$358.72
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$377.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$377.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$283.20
|
| Rate for Payer: Healthfirst Commercial |
$377.60
|
| Rate for Payer: Healthfirst Essential Plan |
$849.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$358.72
|
| Rate for Payer: Healthfirst QHP |
$377.60
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$264.32
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$377.60
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$320.96
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$264.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$377.60
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$283.20
|
| Rate for Payer: SOMOS Essential |
$283.20
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$377.60
|
|
|
PR EXCISION/UNROOFING CYST KIDNEY
|
Professional
|
Both
|
$4,072.50
|
|
|
Service Code
|
HCPCS 50280
|
| Min. Negotiated Rate |
$752.20 |
| Max. Negotiated Rate |
$2,417.78 |
| Rate for Payer: Cash Price |
$1,080.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,074.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$967.11
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$967.11
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,020.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,074.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,020.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,074.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,074.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$805.93
|
| Rate for Payer: Healthfirst Commercial |
$1,074.57
|
| Rate for Payer: Healthfirst Essential Plan |
$2,417.78
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,020.84
|
| Rate for Payer: Healthfirst QHP |
$1,074.57
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$752.20
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,074.57
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$913.38
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$752.20
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,074.57
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$805.93
|
| Rate for Payer: SOMOS Essential |
$805.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,074.57
|
|
|
PR EXCISION VAGINAL CYST/TUMOR
|
Professional
|
Both
|
$820.82
|
|
|
Service Code
|
HCPCS 57135
|
| Min. Negotiated Rate |
$153.92 |
| Max. Negotiated Rate |
$494.73 |
| Rate for Payer: Cash Price |
$221.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$219.88
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$197.89
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$197.89
|
| Rate for Payer: Fidelis Essential Plan QHP |
$208.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$219.88
|
| Rate for Payer: Fidelis Qualified Health Plan |
$208.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$219.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$219.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$164.91
|
| Rate for Payer: Healthfirst Commercial |
$219.88
|
| Rate for Payer: Healthfirst Essential Plan |
$494.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$208.89
|
| Rate for Payer: Healthfirst QHP |
$219.88
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$153.92
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$219.88
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$186.90
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$153.92
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$219.88
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$164.91
|
| Rate for Payer: SOMOS Essential |
$164.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$219.88
|
|
|
PR EXCISION VAGINAL SEPTUM
|
Professional
|
Both
|
$758.10
|
|
|
Service Code
|
HCPCS 57130
|
| Min. Negotiated Rate |
$141.34 |
| Max. Negotiated Rate |
$454.32 |
| Rate for Payer: Cash Price |
$204.57
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$201.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$181.73
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$181.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$191.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$201.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$191.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$201.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$201.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$151.44
|
| Rate for Payer: Healthfirst Commercial |
$201.92
|
| Rate for Payer: Healthfirst Essential Plan |
$454.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$191.82
|
| Rate for Payer: Healthfirst QHP |
$201.92
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$141.34
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$201.92
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$171.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$141.34
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$201.92
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$151.44
|
| Rate for Payer: SOMOS Essential |
$151.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$201.92
|
|
|
PR EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>
|
Professional
|
Both
|
$1,876.07
|
|
|
Service Code
|
HCPCS 27337
|
| Min. Negotiated Rate |
$353.68 |
| Max. Negotiated Rate |
$1,136.84 |
| Rate for Payer: Cash Price |
$506.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$505.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$454.73
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$454.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$480.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$505.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$480.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$505.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$505.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$378.94
|
| Rate for Payer: Healthfirst Commercial |
$505.26
|
| Rate for Payer: Healthfirst Essential Plan |
$1,136.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$480.00
|
| Rate for Payer: Healthfirst QHP |
$505.26
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$353.68
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$505.26
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$429.47
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$353.68
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$505.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$378.94
|
| Rate for Payer: SOMOS Essential |
$378.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$505.26
|
|
|
PR EXC LACRIMAL GLAND TUMOR FRONTAL APPROACH
|
Professional
|
Both
|
$4,074.35
|
|
|
Service Code
|
HCPCS 68540
|
| Min. Negotiated Rate |
$768.03 |
| Max. Negotiated Rate |
$2,468.68 |
| Rate for Payer: Cash Price |
$1,119.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,097.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$987.47
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$987.47
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,042.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,097.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,042.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,097.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,097.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$822.89
|
| Rate for Payer: Healthfirst Commercial |
$1,097.19
|
| Rate for Payer: Healthfirst Essential Plan |
$2,468.68
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,042.33
|
| Rate for Payer: Healthfirst QHP |
$1,097.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$768.03
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,097.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$932.61
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$768.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,097.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$822.89
|
| Rate for Payer: SOMOS Essential |
$822.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,097.19
|
|
