|
PR FETAL CONTRACTION STRESS TEST
|
Professional
|
Both
|
$315.77
|
|
|
Service Code
|
HCPCS 59020
|
| Min. Negotiated Rate |
$58.76 |
| Max. Negotiated Rate |
$188.87 |
| Rate for Payer: Cash Price |
$85.99
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$83.94
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$75.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$75.55
|
| Rate for Payer: Fidelis Essential Plan QHP |
$79.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$83.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$79.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$83.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$83.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$62.95
|
| Rate for Payer: Healthfirst Commercial |
$83.94
|
| Rate for Payer: Healthfirst Essential Plan |
$188.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$79.74
|
| Rate for Payer: Healthfirst QHP |
$83.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$58.76
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$83.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$71.35
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$58.76
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$83.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$62.95
|
| Rate for Payer: SOMOS Essential |
$62.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$83.94
|
|
|
PR FETAL CONTRACTION STRESS TEST
|
Professional
|
Both
|
$169.30
|
|
|
Service Code
|
HCPCS 59020 26
|
| Min. Negotiated Rate |
$30.34 |
| Max. Negotiated Rate |
$97.52 |
| Rate for Payer: Cash Price |
$44.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$43.34
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$39.01
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$39.01
|
| Rate for Payer: Fidelis Essential Plan QHP |
$41.17
|
| Rate for Payer: Fidelis Medicare Advantage |
$43.34
|
| Rate for Payer: Fidelis Qualified Health Plan |
$41.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$43.34
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$43.34
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$32.51
|
| Rate for Payer: Healthfirst Commercial |
$43.34
|
| Rate for Payer: Healthfirst Essential Plan |
$97.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$41.17
|
| Rate for Payer: Healthfirst QHP |
$43.34
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$30.34
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$43.34
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$36.84
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$30.34
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$43.34
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$32.51
|
| Rate for Payer: SOMOS Essential |
$32.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$43.34
|
|
|
PR FETAL CONTRACTION STRESS TEST
|
Professional
|
Both
|
$146.48
|
|
|
Service Code
|
HCPCS 59020 TC
|
| Min. Negotiated Rate |
$28.42 |
| Max. Negotiated Rate |
$91.35 |
| Rate for Payer: Cash Price |
$41.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$40.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$36.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$38.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$40.60
|
| Rate for Payer: Fidelis Qualified Health Plan |
$38.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$40.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30.45
|
| Rate for Payer: Healthfirst Commercial |
$40.60
|
| Rate for Payer: Healthfirst Essential Plan |
$91.35
|
| Rate for Payer: Healthfirst Medicare Advantage |
$38.57
|
| Rate for Payer: Healthfirst QHP |
$40.60
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$28.42
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$40.60
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$34.51
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$28.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$40.60
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$30.45
|
| Rate for Payer: SOMOS Essential |
$30.45
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$40.60
|
|
|
PR FETAL FLUID DRAINAGE W/ULTRASOUND GUIDANCE
|
Professional
|
Both
|
$1,429.58
|
|
|
Service Code
|
HCPCS 59074
|
| Min. Negotiated Rate |
$261.46 |
| Max. Negotiated Rate |
$840.40 |
| Rate for Payer: Cash Price |
$377.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$373.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$336.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$336.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$354.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$373.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$354.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$373.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$373.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$280.13
|
| Rate for Payer: Healthfirst Commercial |
$373.51
|
| Rate for Payer: Healthfirst Essential Plan |
$840.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$354.83
|
| Rate for Payer: Healthfirst QHP |
$373.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$261.46
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$373.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$317.48
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$261.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$373.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$280.13
|
| Rate for Payer: SOMOS Essential |
$280.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$373.51
|
|
|
PR FETAL MONITORING LABOR PHYS WRITTEN REPORT
|
Professional
|
Both
|
$232.93
|
|
|
Service Code
|
HCPCS 59050
|
| Min. Negotiated Rate |
$42.38 |
| Max. Negotiated Rate |
$136.24 |
| Rate for Payer: Cash Price |
$60.67
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$60.55
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$54.49
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$54.49
|
| Rate for Payer: Fidelis Essential Plan QHP |
$57.52
|
| Rate for Payer: Fidelis Medicare Advantage |
$60.55
|
| Rate for Payer: Fidelis Qualified Health Plan |
$57.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$60.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$60.55
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$45.41
|
| Rate for Payer: Healthfirst Commercial |
$60.55
|
| Rate for Payer: Healthfirst Essential Plan |
$136.24
|
| Rate for Payer: Healthfirst Medicare Advantage |
$57.52
|
| Rate for Payer: Healthfirst QHP |
$60.55
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$42.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$60.55
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$51.47
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$42.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$60.55
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$45.41
|
| Rate for Payer: SOMOS Essential |
$45.41
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$60.55
|
|
|
PR FETAL MONITR LABOR PHYS WRTTN REPRT INTERPJ ONLY
|
Professional
|
Both
|
$194.57
|
|
|
Service Code
|
HCPCS 59051
|
| Min. Negotiated Rate |
$35.24 |
| Max. Negotiated Rate |
$113.29 |
| Rate for Payer: Cash Price |
$51.59
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$50.35
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$45.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$45.31
|
| Rate for Payer: Fidelis Essential Plan QHP |
$47.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$50.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$47.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$50.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$50.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$37.76
|
| Rate for Payer: Healthfirst Commercial |
$50.35
|
| Rate for Payer: Healthfirst Essential Plan |
$113.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$47.83
|
| Rate for Payer: Healthfirst QHP |
$50.35
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$35.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$50.35
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$42.80
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$35.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$50.35
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$37.76
|
| Rate for Payer: SOMOS Essential |
$37.76
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$50.35
|
|
|
PR FETAL NONSTRESS TEST
|
Professional
|
Both
|
$129.40
|
|
|
Service Code
|
HCPCS 59025 26
|
| Min. Negotiated Rate |
$24.11 |
| Max. Negotiated Rate |
$77.51 |
| Rate for Payer: Cash Price |
$34.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$34.45
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$31.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$31.00
|
| Rate for Payer: Fidelis Essential Plan QHP |
$32.73
|
| Rate for Payer: Fidelis Medicare Advantage |
$34.45
|
| Rate for Payer: Fidelis Qualified Health Plan |
$32.73
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34.45
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$34.45
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25.84
|
| Rate for Payer: Healthfirst Commercial |
$34.45
|
| Rate for Payer: Healthfirst Essential Plan |
$77.51
|
| Rate for Payer: Healthfirst Medicare Advantage |
$32.73
|
| Rate for Payer: Healthfirst QHP |
$34.45
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$24.11
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$34.45
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$29.28
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$24.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$34.45
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$25.84
|
| Rate for Payer: SOMOS Essential |
$25.84
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$34.45
|
|
|
PR FETAL NONSTRESS TEST
|
Professional
|
Both
|
$216.97
|
|
|
Service Code
|
HCPCS 59025
|
| Min. Negotiated Rate |
$40.84 |
| Max. Negotiated Rate |
$131.29 |
| Rate for Payer: Cash Price |
$59.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$58.35
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$52.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$52.52
|
| Rate for Payer: Fidelis Essential Plan QHP |
$55.43
|
| Rate for Payer: Fidelis Medicare Advantage |
$58.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$55.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$58.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$58.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$43.76
|
| Rate for Payer: Healthfirst Commercial |
$58.35
|
| Rate for Payer: Healthfirst Essential Plan |
$131.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$55.43
|
| Rate for Payer: Healthfirst QHP |
$58.35
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$40.84
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$58.35
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$49.60
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$40.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$58.35
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$43.76
|
| Rate for Payer: SOMOS Essential |
$43.76
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$58.35
|
|
|
PR FETAL NONSTRESS TEST
|
Professional
|
Both
|
$87.54
|
|
|
Service Code
|
HCPCS 59025 TC
|
| Min. Negotiated Rate |
$16.74 |
| Max. Negotiated Rate |
$53.80 |
| Rate for Payer: Cash Price |
$24.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$23.91
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$21.52
|
| Rate for Payer: Fidelis Essential Plan QHP |
$22.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$23.91
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23.91
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$23.91
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.93
|
| Rate for Payer: Healthfirst Commercial |
$23.91
|
| Rate for Payer: Healthfirst Essential Plan |
$53.80
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22.71
|
| Rate for Payer: Healthfirst QHP |
$23.91
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$16.74
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$23.91
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$20.32
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$16.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$23.91
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$17.93
|
| Rate for Payer: SOMOS Essential |
$17.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$23.91
|
|
|
PR FETAL SCALP BLOOD SAMPLING
|
Professional
|
Both
|
$521.36
|
|
|
Service Code
|
HCPCS 59030
|
| Min. Negotiated Rate |
$94.87 |
| Max. Negotiated Rate |
$304.94 |
| Rate for Payer: Cash Price |
$137.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$135.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$121.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$121.98
|
| Rate for Payer: Fidelis Essential Plan QHP |
$128.75
|
| Rate for Payer: Fidelis Medicare Advantage |
$135.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$128.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$135.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$135.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$101.65
|
| Rate for Payer: Healthfirst Commercial |
$135.53
|
| Rate for Payer: Healthfirst Essential Plan |
$304.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$128.75
|
| Rate for Payer: Healthfirst QHP |
$135.53
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$94.87
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$135.53
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$115.20
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$94.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$135.53
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$101.65
|
| Rate for Payer: SOMOS Essential |
$101.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$135.53
|
|
|
PR FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE
|
Professional
|
Both
|
$2,416.89
|
|
|
Service Code
|
HCPCS 59076
|
| Min. Negotiated Rate |
$441.04 |
| Max. Negotiated Rate |
$1,417.63 |
| Rate for Payer: Cash Price |
$637.65
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$630.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$567.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$567.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$598.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$630.06
|
| Rate for Payer: Fidelis Qualified Health Plan |
$598.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$630.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$630.06
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$472.55
|
| Rate for Payer: Healthfirst Commercial |
$630.06
|
| Rate for Payer: Healthfirst Essential Plan |
$1,417.63
|
| Rate for Payer: Healthfirst Medicare Advantage |
$598.56
|
| Rate for Payer: Healthfirst QHP |
$630.06
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$441.04
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$630.06
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$535.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$441.04
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$630.06
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$472.55
|
| Rate for Payer: SOMOS Essential |
$472.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$630.06
|
|
|
PR FETAL UMBILICAL CORD OCCLUSION W/ULTRSND GUIDNCE
|
Professional
|
Both
|
$2,416.89
|
|
|
Service Code
|
HCPCS 59072
|
| Min. Negotiated Rate |
$441.04 |
| Max. Negotiated Rate |
$1,417.63 |
| Rate for Payer: Cash Price |
$637.65
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$630.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$567.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$567.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$598.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$630.06
|
| Rate for Payer: Fidelis Qualified Health Plan |
$598.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$630.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$630.06
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$472.55
|
| Rate for Payer: Healthfirst Commercial |
$630.06
|
| Rate for Payer: Healthfirst Essential Plan |
$1,417.63
|
| Rate for Payer: Healthfirst Medicare Advantage |
$598.56
|
| Rate for Payer: Healthfirst QHP |
$630.06
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$441.04
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$630.06
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$535.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$441.04
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$630.06
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$472.55
|
| Rate for Payer: SOMOS Essential |
$472.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$630.06
|
|
|
PR FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE
|
Professional
|
Both
|
$2,829.09
|
|
|
Service Code
|
HCPCS 14350
|
| Min. Negotiated Rate |
$529.65 |
| Max. Negotiated Rate |
$1,702.44 |
| Rate for Payer: Cash Price |
$774.95
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$756.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$680.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$680.98
|
| Rate for Payer: Fidelis Essential Plan QHP |
$718.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$756.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$718.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$756.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$756.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$567.48
|
| Rate for Payer: Healthfirst Commercial |
$756.64
|
| Rate for Payer: Healthfirst Essential Plan |
$1,702.44
|
| Rate for Payer: Healthfirst Medicare Advantage |
$718.81
|
| Rate for Payer: Healthfirst QHP |
$756.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$529.65
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$756.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$643.14
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$529.65
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$756.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$567.48
|
| Rate for Payer: SOMOS Essential |
$567.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$756.64
|
|
|
PR FILTERED SPEECH TEST
|
Professional
|
Both
|
$130.69
|
|
|
Service Code
|
HCPCS 92571
|
| Min. Negotiated Rate |
$25.25 |
| Max. Negotiated Rate |
$83.47 |
| Rate for Payer: Amida Care Medicaid |
$25.25
|
| Rate for Payer: Cash Price |
$36.78
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$37.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$33.39
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$33.39
|
| Rate for Payer: Fidelis Essential Plan QHP |
$35.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$37.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$35.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$37.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$37.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$27.82
|
| Rate for Payer: Healthfirst Commercial |
$37.10
|
| Rate for Payer: Healthfirst Essential Plan |
$83.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$35.24
|
| Rate for Payer: Healthfirst QHP |
$37.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$25.97
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$37.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$31.54
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$25.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$37.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$27.82
|
| Rate for Payer: SOMOS Essential |
$27.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$37.10
|
|
|
PR FIMBRIOPLASTY
|
Professional
|
Both
|
$3,585.96
|
|
|
Service Code
|
HCPCS 58760
|
| Min. Negotiated Rate |
$665.78 |
| Max. Negotiated Rate |
$2,140.02 |
| Rate for Payer: Cash Price |
$965.64
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$951.12
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$856.01
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$856.01
|
| Rate for Payer: Fidelis Essential Plan QHP |
$903.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$951.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$903.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$951.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$951.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$713.34
|
| Rate for Payer: Healthfirst Commercial |
$951.12
|
| Rate for Payer: Healthfirst Essential Plan |
$2,140.02
|
| Rate for Payer: Healthfirst Medicare Advantage |
$903.56
|
| Rate for Payer: Healthfirst QHP |
$951.12
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$665.78
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$951.12
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$808.45
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$665.78
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$951.12
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$713.34
|
| Rate for Payer: SOMOS Essential |
$713.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$951.12
|
|
|
PR FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION
|
Professional
|
Both
|
$449.65
|
|
|
Service Code
|
HCPCS 10009
|
| Min. Negotiated Rate |
$83.85 |
| Max. Negotiated Rate |
$269.53 |
| Rate for Payer: Cash Price |
$120.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$119.79
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$107.81
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$107.81
|
| Rate for Payer: Fidelis Essential Plan QHP |
$113.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$119.79
|
| Rate for Payer: Fidelis Qualified Health Plan |
$113.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$119.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$119.79
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$89.84
|
| Rate for Payer: Healthfirst Commercial |
$119.79
|
| Rate for Payer: Healthfirst Essential Plan |
$269.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$113.80
|
| Rate for Payer: Healthfirst QHP |
$119.79
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$83.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$119.79
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$101.82
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$83.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$119.79
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$89.84
|
| Rate for Payer: SOMOS Essential |
$89.84
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$119.79
|
|
|
PR FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL
|
Professional
|
Both
|
$298.90
|
|
|
Service Code
|
HCPCS 10010
|
| Min. Negotiated Rate |
$56.76 |
| Max. Negotiated Rate |
$182.43 |
| Rate for Payer: Cash Price |
$81.29
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$81.08
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$72.97
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$72.97
|
| Rate for Payer: Fidelis Essential Plan QHP |
$77.03
|
| Rate for Payer: Fidelis Medicare Advantage |
$81.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$77.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$81.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$81.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$60.81
|
| Rate for Payer: Healthfirst Commercial |
$81.08
|
| Rate for Payer: Healthfirst Essential Plan |
$182.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$77.03
|
| Rate for Payer: Healthfirst QHP |
$81.08
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$56.76
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$81.08
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$68.92
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$56.76
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$81.08
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$60.81
|
| Rate for Payer: SOMOS Essential |
$60.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$81.08
|
|
|
PR FINE NEEDLE ASPIRATION BX W/FLUOR GDN 1ST LESION
|
Professional
|
Both
|
$367.82
|
|
|
Service Code
|
HCPCS 10007
|
| Min. Negotiated Rate |
$70.45 |
| Max. Negotiated Rate |
$226.44 |
| Rate for Payer: Cash Price |
$101.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$100.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$90.58
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$90.58
|
| Rate for Payer: Fidelis Essential Plan QHP |
$95.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$100.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$95.61
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$100.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$100.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$75.48
|
| Rate for Payer: Healthfirst Commercial |
$100.64
|
| Rate for Payer: Healthfirst Essential Plan |
$226.44
|
| Rate for Payer: Healthfirst Medicare Advantage |
$95.61
|
| Rate for Payer: Healthfirst QHP |
$100.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$70.45
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$100.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$85.54
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$70.45
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$100.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$75.48
|
| Rate for Payer: SOMOS Essential |
$75.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$100.64
|
|
|
PR FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL
|
Professional
|
Both
|
$223.06
|
|
|
Service Code
|
HCPCS 10008
|
| Min. Negotiated Rate |
$41.08 |
| Max. Negotiated Rate |
$132.05 |
| Rate for Payer: Cash Price |
$58.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$58.69
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$52.82
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$52.82
|
| Rate for Payer: Fidelis Essential Plan QHP |
$55.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$58.69
|
| Rate for Payer: Fidelis Qualified Health Plan |
$55.76
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$58.69
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$58.69
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$44.02
|
| Rate for Payer: Healthfirst Commercial |
$58.69
|
| Rate for Payer: Healthfirst Essential Plan |
$132.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$55.76
|
| Rate for Payer: Healthfirst QHP |
$58.69
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$41.08
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$58.69
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$49.89
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$41.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$58.69
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$44.02
|
| Rate for Payer: SOMOS Essential |
$44.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$58.69
|
|
|
PR FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION
|
Professional
|
Both
|
$233.45
|
|
|
Service Code
|
HCPCS 10021
|
| Min. Negotiated Rate |
$44.10 |
| Max. Negotiated Rate |
$141.75 |
| Rate for Payer: Cash Price |
$62.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$63.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$56.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$56.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$59.85
|
| Rate for Payer: Fidelis Medicare Advantage |
$63.00
|
| Rate for Payer: Fidelis Qualified Health Plan |
$59.85
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$63.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$63.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$47.25
|
| Rate for Payer: Healthfirst Commercial |
$63.00
|
| Rate for Payer: Healthfirst Essential Plan |
$141.75
|
| Rate for Payer: Healthfirst Medicare Advantage |
$59.85
|
| Rate for Payer: Healthfirst QHP |
$63.00
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$44.10
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$63.00
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$53.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$44.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$63.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$47.25
|
| Rate for Payer: SOMOS Essential |
$47.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$63.00
|
|
|
PR FINE NEEDLE ASPIRATION BX W/O IMG GDN EA ADDL
|
Professional
|
Both
|
$180.60
|
|
|
Service Code
|
HCPCS 10004
|
| Min. Negotiated Rate |
$34.97 |
| Max. Negotiated Rate |
$112.41 |
| Rate for Payer: Cash Price |
$50.18
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$49.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$44.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$44.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$47.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$49.96
|
| Rate for Payer: Fidelis Qualified Health Plan |
$47.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$49.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$49.96
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$37.47
|
| Rate for Payer: Healthfirst Commercial |
$49.96
|
| Rate for Payer: Healthfirst Essential Plan |
$112.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$47.46
|
| Rate for Payer: Healthfirst QHP |
$49.96
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$34.97
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$49.96
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$42.47
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$34.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$49.96
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$37.47
|
| Rate for Payer: SOMOS Essential |
$37.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$49.96
|
|
|
PR FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION
|
Professional
|
Both
|
$308.46
|
|
|
Service Code
|
HCPCS 10005
|
| Min. Negotiated Rate |
$57.07 |
| Max. Negotiated Rate |
$183.44 |
| Rate for Payer: Cash Price |
$82.14
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$81.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$73.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$73.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$77.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$81.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$77.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$81.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$81.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$61.15
|
| Rate for Payer: Healthfirst Commercial |
$81.53
|
| Rate for Payer: Healthfirst Essential Plan |
$183.44
|
| Rate for Payer: Healthfirst Medicare Advantage |
$77.45
|
| Rate for Payer: Healthfirst QHP |
$81.53
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$57.07
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$81.53
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$69.30
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$57.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$81.53
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$61.15
|
| Rate for Payer: SOMOS Essential |
$61.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$81.53
|
|
|
PR FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL
|
Professional
|
Both
|
$207.24
|
|
|
Service Code
|
HCPCS 10006
|
| Min. Negotiated Rate |
$38.77 |
| Max. Negotiated Rate |
$124.61 |
| Rate for Payer: Cash Price |
$56.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$55.38
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$49.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$49.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$52.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$55.38
|
| Rate for Payer: Fidelis Qualified Health Plan |
$52.61
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$55.38
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$55.38
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$41.53
|
| Rate for Payer: Healthfirst Commercial |
$55.38
|
| Rate for Payer: Healthfirst Essential Plan |
$124.61
|
| Rate for Payer: Healthfirst Medicare Advantage |
$52.61
|
| Rate for Payer: Healthfirst QHP |
$55.38
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$38.77
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$55.38
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$47.07
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$38.77
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$55.38
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$41.53
|
| Rate for Payer: SOMOS Essential |
$41.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$55.38
|
|
|
PR FINE NEEDLE ASPIRATION ORBITAL CONTENTS
|
Professional
|
Both
|
$418.32
|
|
|
Service Code
|
HCPCS 67415
|
| Min. Negotiated Rate |
$79.91 |
| Max. Negotiated Rate |
$256.84 |
| Rate for Payer: Cash Price |
$114.54
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$114.15
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$102.73
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$102.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$108.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$114.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$108.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$114.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$114.15
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$85.61
|
| Rate for Payer: Healthfirst Commercial |
$114.15
|
| Rate for Payer: Healthfirst Essential Plan |
$256.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$108.44
|
| Rate for Payer: Healthfirst QHP |
$114.15
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$79.91
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$114.15
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$97.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$79.91
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$114.15
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$85.61
|
| Rate for Payer: SOMOS Essential |
$85.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$114.15
|
|
|
PR FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED
|
Professional
|
Both
|
$1,470.56
|
|
|
Service Code
|
HCPCS 46200
|
| Min. Negotiated Rate |
$280.18 |
| Max. Negotiated Rate |
$900.56 |
| Rate for Payer: Cash Price |
$401.48
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$400.25
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$360.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$360.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$380.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$400.25
|
| Rate for Payer: Fidelis Qualified Health Plan |
$380.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$400.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$400.25
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$300.19
|
| Rate for Payer: Healthfirst Commercial |
$400.25
|
| Rate for Payer: Healthfirst Essential Plan |
$900.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$380.24
|
| Rate for Payer: Healthfirst QHP |
$400.25
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$280.18
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$400.25
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$340.21
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$280.18
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$400.25
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$300.19
|
| Rate for Payer: SOMOS Essential |
$300.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$400.25
|
|
