|
PR EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM
|
Professional
|
Both
|
$2,298.42
|
|
|
Service Code
|
HCPCS 25076
|
| Min. Negotiated Rate |
$435.34 |
| Max. Negotiated Rate |
$1,399.30 |
| Rate for Payer: Cash Price |
$623.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$621.91
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$559.72
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$559.72
|
| Rate for Payer: Fidelis Essential Plan QHP |
$590.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$621.91
|
| Rate for Payer: Fidelis Qualified Health Plan |
$590.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$621.91
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$621.91
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$466.43
|
| Rate for Payer: Healthfirst Commercial |
$621.91
|
| Rate for Payer: Healthfirst Essential Plan |
$1,399.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$590.81
|
| Rate for Payer: Healthfirst QHP |
$621.91
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$435.34
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$621.91
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$528.62
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$435.34
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$621.91
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$466.43
|
| Rate for Payer: SOMOS Essential |
$466.43
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$621.91
|
|
|
PR EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM
|
Professional
|
Both
|
$2,346.16
|
|
|
Service Code
|
HCPCS 21556
|
| Min. Negotiated Rate |
$438.52 |
| Max. Negotiated Rate |
$1,409.54 |
| Rate for Payer: Cash Price |
$631.32
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$626.46
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$563.81
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$563.81
|
| Rate for Payer: Fidelis Essential Plan QHP |
$595.14
|
| Rate for Payer: Fidelis Medicare Advantage |
$626.46
|
| Rate for Payer: Fidelis Qualified Health Plan |
$595.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$626.46
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$626.46
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$469.85
|
| Rate for Payer: Healthfirst Commercial |
$626.46
|
| Rate for Payer: Healthfirst Essential Plan |
$1,409.54
|
| Rate for Payer: Healthfirst Medicare Advantage |
$595.14
|
| Rate for Payer: Healthfirst QHP |
$626.46
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$438.52
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$626.46
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$532.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$438.52
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$626.46
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$469.85
|
| Rate for Payer: SOMOS Essential |
$469.85
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$626.46
|
|
|
PR EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM
|
Professional
|
Both
|
$2,423.89
|
|
|
Service Code
|
HCPCS 23076
|
| Min. Negotiated Rate |
$457.57 |
| Max. Negotiated Rate |
$1,470.76 |
| Rate for Payer: Cash Price |
$654.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$653.67
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$588.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$588.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$620.99
|
| Rate for Payer: Fidelis Medicare Advantage |
$653.67
|
| Rate for Payer: Fidelis Qualified Health Plan |
$620.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$653.67
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$653.67
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$490.25
|
| Rate for Payer: Healthfirst Commercial |
$653.67
|
| Rate for Payer: Healthfirst Essential Plan |
$1,470.76
|
| Rate for Payer: Healthfirst Medicare Advantage |
$620.99
|
| Rate for Payer: Healthfirst QHP |
$653.67
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$457.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$653.67
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$555.62
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$457.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$653.67
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$490.25
|
| Rate for Payer: SOMOS Essential |
$490.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$653.67
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM
|
Professional
|
Both
|
$2,536.42
|
|
|
Service Code
|
HCPCS 22900
|
| Min. Negotiated Rate |
$475.38 |
| Max. Negotiated Rate |
$1,528.00 |
| Rate for Payer: Cash Price |
$682.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$679.11
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$611.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$611.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$645.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$679.11
|
| Rate for Payer: Fidelis Qualified Health Plan |
$645.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$679.11
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$679.11
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$509.33
|
| Rate for Payer: Healthfirst Commercial |
$679.11
|
| Rate for Payer: Healthfirst Essential Plan |
$1,528.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$645.15
|
| Rate for Payer: Healthfirst QHP |
$679.11
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$475.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$679.11
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$577.24
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$475.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$679.11
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$509.33
|
| Rate for Payer: SOMOS Essential |
$509.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$679.11
|
|
|
PR EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5CM/>
|
Professional
|
Both
|
$2,994.15
|
|
|
Service Code
|
HCPCS 22901
|
| Min. Negotiated Rate |
$559.58 |
| Max. Negotiated Rate |
$1,798.65 |
| Rate for Payer: Cash Price |
$803.17
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$799.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$719.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$719.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$759.43
|
| Rate for Payer: Fidelis Medicare Advantage |
$799.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$759.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$799.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$799.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$599.55
|
| Rate for Payer: Healthfirst Commercial |
$799.40
|
| Rate for Payer: Healthfirst Essential Plan |
$1,798.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$759.43
|
| Rate for Payer: Healthfirst QHP |
$799.40
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$559.58
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$799.40
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$679.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$559.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$799.40
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$599.55
|
| Rate for Payer: SOMOS Essential |
$599.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$799.40
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>
|
Professional
|
Both
|
$1,983.73
|
|
|
Service Code
|
HCPCS 22903
|
| Min. Negotiated Rate |
$371.14 |
| Max. Negotiated Rate |
$1,192.95 |
| Rate for Payer: Cash Price |
$532.63
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$530.20
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$477.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$477.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$503.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$530.20
|
| Rate for Payer: Fidelis Qualified Health Plan |
$503.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$530.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$530.20
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$397.65
|
| Rate for Payer: Healthfirst Commercial |
$530.20
|
| Rate for Payer: Healthfirst Essential Plan |
$1,192.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$503.69
|
| Rate for Payer: Healthfirst QHP |
$530.20
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$371.14
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$530.20
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$450.67
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$371.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$530.20
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$397.65
|
| Rate for Payer: SOMOS Essential |
$397.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$530.20
|
|
|
PR EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM
|
Professional
|
Both
|
$1,492.51
|
|
|
Service Code
|
HCPCS 22902
|
| Min. Negotiated Rate |
$281.30 |
| Max. Negotiated Rate |
$904.18 |
| Rate for Payer: Cash Price |
$404.36
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$401.86
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$361.67
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$361.67
|
| Rate for Payer: Fidelis Essential Plan QHP |
$381.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$401.86
|
| Rate for Payer: Fidelis Qualified Health Plan |
$381.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$401.86
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$401.86
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$301.39
|
| Rate for Payer: Healthfirst Commercial |
$401.86
|
| Rate for Payer: Healthfirst Essential Plan |
$904.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$381.77
|
| Rate for Payer: Healthfirst QHP |
$401.86
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$281.30
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$401.86
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$341.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$281.30
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$401.86
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$301.39
|
| Rate for Payer: SOMOS Essential |
$301.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$401.86
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5 CM/>
|
Professional
|
Both
|
$1,906.56
|
|
|
Service Code
|
HCPCS 28041
|
| Min. Negotiated Rate |
$363.65 |
| Max. Negotiated Rate |
$1,168.88 |
| Rate for Payer: Cash Price |
$523.84
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$519.50
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$467.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$467.55
|
| Rate for Payer: Fidelis Essential Plan QHP |
$493.52
|
| Rate for Payer: Fidelis Medicare Advantage |
$519.50
|
| Rate for Payer: Fidelis Qualified Health Plan |
$493.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$519.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$519.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$389.62
|
| Rate for Payer: Healthfirst Commercial |
$519.50
|
| Rate for Payer: Healthfirst Essential Plan |
$1,168.88
|
| Rate for Payer: Healthfirst Medicare Advantage |
$493.52
|
| Rate for Payer: Healthfirst QHP |
$519.50
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$363.65
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$519.50
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$441.57
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$363.65
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$519.50
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$389.62
|
| Rate for Payer: SOMOS Essential |
$389.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$519.50
|
|
|
PR EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM
|
Professional
|
Both
|
$1,458.66
|
|
|
Service Code
|
HCPCS 28045
|
| Min. Negotiated Rate |
$281.25 |
| Max. Negotiated Rate |
$904.00 |
| Rate for Payer: Cash Price |
$400.59
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$401.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$361.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$361.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$381.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$401.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$381.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$401.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$401.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$301.33
|
| Rate for Payer: Healthfirst Commercial |
$401.78
|
| Rate for Payer: Healthfirst Essential Plan |
$904.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$381.69
|
| Rate for Payer: Healthfirst QHP |
$401.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$281.25
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$401.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$341.51
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$281.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$401.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$301.33
|
| Rate for Payer: SOMOS Essential |
$301.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$401.78
|
|
|
PR EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM
|
Professional
|
Both
|
$1,402.14
|
|
|
Service Code
|
HCPCS 25075
|
| Min. Negotiated Rate |
$265.69 |
| Max. Negotiated Rate |
$854.01 |
| Rate for Payer: Cash Price |
$380.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$379.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$341.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$341.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$360.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$379.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$360.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$379.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$379.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$284.67
|
| Rate for Payer: Healthfirst Commercial |
$379.56
|
| Rate for Payer: Healthfirst Essential Plan |
$854.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$360.58
|
| Rate for Payer: Healthfirst QHP |
$379.56
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$265.69
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$379.56
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$322.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$265.69
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$379.56
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$284.67
|
| Rate for Payer: SOMOS Essential |
$284.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$379.56
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5 CM/>
|
Professional
|
Both
|
$2,985.22
|
|
|
Service Code
|
HCPCS 27634
|
| Min. Negotiated Rate |
$554.99 |
| Max. Negotiated Rate |
$1,783.89 |
| Rate for Payer: Cash Price |
$800.54
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$792.84
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$713.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$713.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$753.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$792.84
|
| Rate for Payer: Fidelis Qualified Health Plan |
$753.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$792.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$792.84
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$594.63
|
| Rate for Payer: Healthfirst Commercial |
$792.84
|
| Rate for Payer: Healthfirst Essential Plan |
$1,783.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$753.20
|
| Rate for Payer: Healthfirst QHP |
$792.84
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$554.99
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$792.84
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$673.91
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$554.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$792.84
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$594.63
|
| Rate for Payer: SOMOS Essential |
$594.63
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$792.84
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM
|
Professional
|
Both
|
$2,042.64
|
|
|
Service Code
|
HCPCS 27619
|
| Min. Negotiated Rate |
$384.74 |
| Max. Negotiated Rate |
$1,236.67 |
| Rate for Payer: Cash Price |
$558.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$549.63
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$494.67
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$494.67
|
| Rate for Payer: Fidelis Essential Plan QHP |
$522.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$549.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$522.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$549.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$549.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$412.22
|
| Rate for Payer: Healthfirst Commercial |
$549.63
|
| Rate for Payer: Healthfirst Essential Plan |
$1,236.67
|
| Rate for Payer: Healthfirst Medicare Advantage |
$522.15
|
| Rate for Payer: Healthfirst QHP |
$549.63
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$384.74
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$549.63
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$467.19
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$384.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$549.63
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$412.22
|
| Rate for Payer: SOMOS Essential |
$412.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$549.63
|
|
|
PR EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM
|
Professional
|
Both
|
$1,346.77
|
|
|
Service Code
|
HCPCS 27618
|
| Min. Negotiated Rate |
$255.16 |
| Max. Negotiated Rate |
$820.15 |
| Rate for Payer: Cash Price |
$366.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$364.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$328.06
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$328.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$346.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$364.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$346.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$364.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$364.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$273.38
|
| Rate for Payer: Healthfirst Commercial |
$364.51
|
| Rate for Payer: Healthfirst Essential Plan |
$820.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$346.28
|
| Rate for Payer: Healthfirst QHP |
$364.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$255.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$364.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$309.83
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$255.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$364.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$273.38
|
| Rate for Payer: SOMOS Essential |
$273.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$364.51
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM
|
Professional
|
Both
|
$1,357.58
|
|
|
Service Code
|
HCPCS 21555
|
| Min. Negotiated Rate |
$256.89 |
| Max. Negotiated Rate |
$825.71 |
| Rate for Payer: Cash Price |
$368.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$366.98
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$330.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$330.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$348.63
|
| Rate for Payer: Fidelis Medicare Advantage |
$366.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$348.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$366.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$366.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$275.24
|
| Rate for Payer: Healthfirst Commercial |
$366.98
|
| Rate for Payer: Healthfirst Essential Plan |
$825.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$348.63
|
| Rate for Payer: Healthfirst QHP |
$366.98
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$256.89
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$366.98
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$311.93
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$256.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$366.98
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$275.24
|
| Rate for Payer: SOMOS Essential |
$275.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$366.98
|
|
|
PR EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5 CM/>
|
Professional
|
Both
|
$3,253.15
|
|
|
Service Code
|
HCPCS 21554
|
| Min. Negotiated Rate |
$608.58 |
| Max. Negotiated Rate |
$1,956.15 |
| Rate for Payer: Cash Price |
$874.82
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$869.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$782.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$782.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$825.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$869.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$825.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$869.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$869.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$652.05
|
| Rate for Payer: Healthfirst Commercial |
$869.40
|
| Rate for Payer: Healthfirst Essential Plan |
$1,956.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$825.93
|
| Rate for Payer: Healthfirst QHP |
$869.40
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$608.58
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$869.40
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$738.99
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$608.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$869.40
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$652.05
|
| Rate for Payer: SOMOS Essential |
$652.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$869.40
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM
|
Professional
|
Both
|
$2,737.11
|
|
|
Service Code
|
HCPCS 27048
|
| Min. Negotiated Rate |
$514.34 |
| Max. Negotiated Rate |
$1,653.23 |
| Rate for Payer: Cash Price |
$737.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$734.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$661.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$661.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$698.03
|
| Rate for Payer: Fidelis Medicare Advantage |
$734.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$698.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$734.77
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$734.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$551.08
|
| Rate for Payer: Healthfirst Commercial |
$734.77
|
| Rate for Payer: Healthfirst Essential Plan |
$1,653.23
|
| Rate for Payer: Healthfirst Medicare Advantage |
$698.03
|
| Rate for Payer: Healthfirst QHP |
$734.77
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$514.34
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$734.77
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$624.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$514.34
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$734.77
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$551.08
|
| Rate for Payer: SOMOS Essential |
$551.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$734.77
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5CM/>
|
Professional
|
Both
|
$3,274.57
|
|
|
Service Code
|
HCPCS 27045
|
| Min. Negotiated Rate |
$611.57 |
| Max. Negotiated Rate |
$1,965.76 |
| Rate for Payer: Cash Price |
$876.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$873.67
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$786.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$786.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$829.99
|
| Rate for Payer: Fidelis Medicare Advantage |
$873.67
|
| Rate for Payer: Fidelis Qualified Health Plan |
$829.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$873.67
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$873.67
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$655.25
|
| Rate for Payer: Healthfirst Commercial |
$873.67
|
| Rate for Payer: Healthfirst Essential Plan |
$1,965.76
|
| Rate for Payer: Healthfirst Medicare Advantage |
$829.99
|
| Rate for Payer: Healthfirst QHP |
$873.67
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$611.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$873.67
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$742.62
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$611.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$873.67
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$655.25
|
| Rate for Payer: SOMOS Essential |
$655.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$873.67
|
|
|
PR EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM
|
Professional
|
Both
|
$1,608.53
|
|
|
Service Code
|
HCPCS 27047
|
| Min. Negotiated Rate |
$303.12 |
| Max. Negotiated Rate |
$974.32 |
| Rate for Payer: Cash Price |
$436.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$433.03
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$389.73
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$389.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$411.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$433.03
|
| Rate for Payer: Fidelis Qualified Health Plan |
$411.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$433.03
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$433.03
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$324.77
|
| Rate for Payer: Healthfirst Commercial |
$433.03
|
| Rate for Payer: Healthfirst Essential Plan |
$974.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$411.38
|
| Rate for Payer: Healthfirst QHP |
$433.03
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$303.12
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$433.03
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$368.08
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$303.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$433.03
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$324.77
|
| Rate for Payer: SOMOS Essential |
$324.77
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$433.03
|
|
|
PR EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>
|
Professional
|
Both
|
$3,113.60
|
|
|
Service Code
|
HCPCS 23073
|
| Min. Negotiated Rate |
$583.02 |
| Max. Negotiated Rate |
$1,874.00 |
| Rate for Payer: Cash Price |
$837.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$832.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$749.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$749.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$791.25
|
| Rate for Payer: Fidelis Medicare Advantage |
$832.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$791.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$832.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$832.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$624.67
|
| Rate for Payer: Healthfirst Commercial |
$832.89
|
| Rate for Payer: Healthfirst Essential Plan |
$1,874.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$791.25
|
| Rate for Payer: Healthfirst QHP |
$832.89
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$583.02
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$832.89
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$707.96
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$583.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$832.89
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$624.67
|
| Rate for Payer: SOMOS Essential |
$624.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$832.89
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5 CM/>
|
Professional
|
Both
|
$3,362.45
|
|
|
Service Code
|
HCPCS 27339
|
| Min. Negotiated Rate |
$631.38 |
| Max. Negotiated Rate |
$2,029.43 |
| Rate for Payer: Cash Price |
$907.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$901.97
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$811.77
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$811.77
|
| Rate for Payer: Fidelis Essential Plan QHP |
$856.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$901.97
|
| Rate for Payer: Fidelis Qualified Health Plan |
$856.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$901.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$901.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$676.48
|
| Rate for Payer: Healthfirst Commercial |
$901.97
|
| Rate for Payer: Healthfirst Essential Plan |
$2,029.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$856.87
|
| Rate for Payer: Healthfirst QHP |
$901.97
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$631.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$901.97
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$766.67
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$631.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$901.97
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$676.48
|
| Rate for Payer: SOMOS Essential |
$676.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$901.97
|
|
|
PR EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM
|
Professional
|
Both
|
$2,785.09
|
|
|
Service Code
|
HCPCS 27328
|
| Min. Negotiated Rate |
$522.27 |
| Max. Negotiated Rate |
$1,678.72 |
| Rate for Payer: Cash Price |
$751.19
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$746.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$671.49
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$671.49
|
| Rate for Payer: Fidelis Essential Plan QHP |
$708.79
|
| Rate for Payer: Fidelis Medicare Advantage |
$746.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$708.79
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$746.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$746.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$559.58
|
| Rate for Payer: Healthfirst Commercial |
$746.10
|
| Rate for Payer: Healthfirst Essential Plan |
$1,678.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$708.79
|
| Rate for Payer: Healthfirst QHP |
$746.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$522.27
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$746.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$634.18
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$522.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$746.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$559.58
|
| Rate for Payer: SOMOS Essential |
$559.58
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$746.10
|
|
|
PR EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>
|
Professional
|
Both
|
$1,814.51
|
|
|
Service Code
|
HCPCS 24071
|
| Min. Negotiated Rate |
$341.08 |
| Max. Negotiated Rate |
$1,096.34 |
| Rate for Payer: Cash Price |
$488.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$487.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$438.53
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$438.53
|
| Rate for Payer: Fidelis Essential Plan QHP |
$462.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$487.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$462.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$487.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$487.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$365.44
|
| Rate for Payer: Healthfirst Commercial |
$487.26
|
| Rate for Payer: Healthfirst Essential Plan |
$1,096.34
|
| Rate for Payer: Healthfirst Medicare Advantage |
$462.90
|
| Rate for Payer: Healthfirst QHP |
$487.26
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$341.08
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$487.26
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$414.17
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$341.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$487.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$365.44
|
| Rate for Payer: SOMOS Essential |
$365.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$487.26
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM
|
Professional
|
Both
|
$1,468.88
|
|
|
Service Code
|
HCPCS 24075
|
| Min. Negotiated Rate |
$276.99 |
| Max. Negotiated Rate |
$890.33 |
| Rate for Payer: Cash Price |
$397.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$395.70
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$356.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$356.13
|
| Rate for Payer: Fidelis Essential Plan QHP |
$375.92
|
| Rate for Payer: Fidelis Medicare Advantage |
$395.70
|
| Rate for Payer: Fidelis Qualified Health Plan |
$375.92
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$395.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$395.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$296.77
|
| Rate for Payer: Healthfirst Commercial |
$395.70
|
| Rate for Payer: Healthfirst Essential Plan |
$890.33
|
| Rate for Payer: Healthfirst Medicare Advantage |
$375.92
|
| Rate for Payer: Healthfirst QHP |
$395.70
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$276.99
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$395.70
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$336.35
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$276.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$395.70
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$296.77
|
| Rate for Payer: SOMOS Essential |
$296.77
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$395.70
|
|
|
PR EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5CM/>
|
Professional
|
Both
|
$3,089.87
|
|
|
Service Code
|
HCPCS 24073
|
| Min. Negotiated Rate |
$580.58 |
| Max. Negotiated Rate |
$1,866.15 |
| Rate for Payer: Cash Price |
$831.74
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$829.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$746.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$746.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$787.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$829.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$787.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$829.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$829.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$622.05
|
| Rate for Payer: Healthfirst Commercial |
$829.40
|
| Rate for Payer: Healthfirst Essential Plan |
$1,866.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$787.93
|
| Rate for Payer: Healthfirst QHP |
$829.40
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$580.58
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$829.40
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$704.99
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$580.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$829.40
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$622.05
|
| Rate for Payer: SOMOS Essential |
$622.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$829.40
|
|
|
PR EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM
|
Professional
|
Both
|
$2,436.21
|
|
|
Service Code
|
HCPCS 24076
|
| Min. Negotiated Rate |
$458.62 |
| Max. Negotiated Rate |
$1,474.13 |
| Rate for Payer: Cash Price |
$657.17
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$655.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$589.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$589.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$622.41
|
| Rate for Payer: Fidelis Medicare Advantage |
$655.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$622.41
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$655.17
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$655.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$491.38
|
| Rate for Payer: Healthfirst Commercial |
$655.17
|
| Rate for Payer: Healthfirst Essential Plan |
$1,474.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$622.41
|
| Rate for Payer: Healthfirst QHP |
$655.17
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$458.62
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$655.17
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$556.89
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$458.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$655.17
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$491.38
|
| Rate for Payer: SOMOS Essential |
$491.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$655.17
|
|
