|
PR HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN
|
Professional
|
Both
|
$34.79
|
|
|
Service Code
|
HCPCS 96164
|
| Min. Negotiated Rate |
$7.34 |
| Max. Negotiated Rate |
$23.58 |
| Rate for Payer: Cash Price |
$10.26
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$10.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$9.43
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.43
|
| Rate for Payer: Fidelis Essential Plan QHP |
$9.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$10.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$9.96
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.86
|
| Rate for Payer: Healthfirst Commercial |
$10.48
|
| Rate for Payer: Healthfirst Essential Plan |
$23.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.96
|
| Rate for Payer: Healthfirst QHP |
$10.48
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$7.34
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$10.48
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$8.91
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$7.34
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$10.48
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$7.86
|
| Rate for Payer: SOMOS Essential |
$7.86
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$10.48
|
|
|
PR HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN
|
Professional
|
Both
|
$15.40
|
|
|
Service Code
|
HCPCS 96165
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$10.28 |
| Rate for Payer: Cash Price |
$4.27
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.11
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.11
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.34
|
| Rate for Payer: Fidelis Medicare Advantage |
$4.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.43
|
| Rate for Payer: Healthfirst Commercial |
$4.57
|
| Rate for Payer: Healthfirst Essential Plan |
$10.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$4.34
|
| Rate for Payer: Healthfirst QHP |
$4.57
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$3.20
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$4.57
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$3.88
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$3.20
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4.57
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3.43
|
| Rate for Payer: SOMOS Essential |
$3.43
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.57
|
|
|
PR HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN
|
Professional
|
Both
|
$221.31
|
|
|
Service Code
|
HCPCS 96158
|
| Min. Negotiated Rate |
$45.78 |
| Max. Negotiated Rate |
$147.15 |
| Rate for Payer: Cash Price |
$63.37
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$65.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$58.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$58.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$62.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$65.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$62.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$65.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$65.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$49.05
|
| Rate for Payer: Healthfirst Commercial |
$65.40
|
| Rate for Payer: Healthfirst Essential Plan |
$147.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$62.13
|
| Rate for Payer: Healthfirst QHP |
$65.40
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$45.78
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$65.40
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$55.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$45.78
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$65.40
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$49.05
|
| Rate for Payer: SOMOS Essential |
$49.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$65.40
|
|
|
PR HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN
|
Professional
|
Both
|
$75.43
|
|
|
Service Code
|
HCPCS 96159
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$50.13 |
| Rate for Payer: Cash Price |
$21.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$22.28
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$20.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$21.17
|
| Rate for Payer: Fidelis Medicare Advantage |
$22.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$22.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.71
|
| Rate for Payer: Healthfirst Commercial |
$22.28
|
| Rate for Payer: Healthfirst Essential Plan |
$50.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$21.17
|
| Rate for Payer: Healthfirst QHP |
$22.28
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$15.60
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$22.28
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$18.94
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$15.60
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$22.28
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$16.71
|
| Rate for Payer: SOMOS Essential |
$16.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$22.28
|
|
|
PR HEART-LUNG TRNSPL W/RECIPIENT CARDIECTOMY-PNUMEC
|
Professional
|
Both
|
$21,686.25
|
|
|
Service Code
|
HCPCS 33935
|
| Min. Negotiated Rate |
$3,988.59 |
| Max. Negotiated Rate |
$12,820.45 |
| Rate for Payer: Cash Price |
$5,750.51
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5,697.98
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$5,128.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,128.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,413.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$5,697.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,413.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5,697.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5,697.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$4,273.48
|
| Rate for Payer: Healthfirst Commercial |
$5,697.98
|
| Rate for Payer: Healthfirst Essential Plan |
$12,820.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,413.08
|
| Rate for Payer: Healthfirst QHP |
$5,697.98
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$3,988.59
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$5,697.98
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$4,843.28
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$3,988.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5,697.98
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$4,273.48
|
| Rate for Payer: SOMOS Essential |
$4,273.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5,697.98
|
|
|
PR HEART TRANSPLANT W/WO RECIPIENT CARDIECTOMY
|
Professional
|
Both
|
$21,523.53
|
|
|
Service Code
|
HCPCS 33945
|
| Min. Negotiated Rate |
$3,960.33 |
| Max. Negotiated Rate |
$12,729.65 |
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$5,657.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$5,091.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$5,091.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$5,374.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$5,657.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$5,374.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$5,657.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$5,657.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$4,243.22
|
| Rate for Payer: Healthfirst Commercial |
$5,657.62
|
| Rate for Payer: Healthfirst Essential Plan |
$12,729.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$5,374.74
|
| Rate for Payer: Healthfirst QHP |
$5,657.62
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$3,960.33
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$5,657.62
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$4,808.98
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$3,960.33
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$5,657.62
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$4,243.22
|
| Rate for Payer: SOMOS Essential |
$4,243.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$5,657.62
|
|
|
PR HEMIARTHROPLASTY HIP PARTIAL
|
Professional
|
Both
|
$4,992.23
|
|
|
Service Code
|
HCPCS 27125
|
| Min. Negotiated Rate |
$938.50 |
| Max. Negotiated Rate |
$3,016.62 |
| Rate for Payer: Cash Price |
$1,346.90
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,340.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,206.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,206.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,273.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,340.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,273.68
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,340.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,340.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,005.54
|
| Rate for Payer: Healthfirst Commercial |
$1,340.72
|
| Rate for Payer: Healthfirst Essential Plan |
$3,016.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,273.68
|
| Rate for Payer: Healthfirst QHP |
$1,340.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$938.50
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,340.72
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,139.61
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$938.50
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,340.72
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,005.54
|
| Rate for Payer: SOMOS Essential |
$1,005.54
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,340.72
|
|
|
PR HEMICORTICAL INTERCALARY ALLOGRAFT PARTIAL
|
Professional
|
Both
|
$3,046.12
|
|
|
Service Code
|
HCPCS 20933
|
| Min. Negotiated Rate |
$564.79 |
| Max. Negotiated Rate |
$1,815.41 |
| Rate for Payer: Cash Price |
$812.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$806.85
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$726.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$726.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$766.51
|
| Rate for Payer: Fidelis Medicare Advantage |
$806.85
|
| Rate for Payer: Fidelis Qualified Health Plan |
$766.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$806.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$806.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$605.14
|
| Rate for Payer: Healthfirst Commercial |
$806.85
|
| Rate for Payer: Healthfirst Essential Plan |
$1,815.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$766.51
|
| Rate for Payer: Healthfirst QHP |
$806.85
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$564.79
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$806.85
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$685.82
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$564.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$806.85
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$605.14
|
| Rate for Payer: SOMOS Essential |
$605.14
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$806.85
|
|
|
PR HEMIEPIPHYSEAL ARREST
|
Professional
|
Both
|
$2,986.80
|
|
|
Service Code
|
HCPCS 24470
|
| Min. Negotiated Rate |
$564.01 |
| Max. Negotiated Rate |
$1,812.89 |
| Rate for Payer: Cash Price |
$809.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$805.73
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$725.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$725.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$765.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$805.73
|
| Rate for Payer: Fidelis Qualified Health Plan |
$765.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$805.73
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$805.73
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$604.30
|
| Rate for Payer: Healthfirst Commercial |
$805.73
|
| Rate for Payer: Healthfirst Essential Plan |
$1,812.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$765.44
|
| Rate for Payer: Healthfirst QHP |
$805.73
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$564.01
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$805.73
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$684.87
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$564.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$805.73
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$604.30
|
| Rate for Payer: SOMOS Essential |
$604.30
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$805.73
|
|
|
PR HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE
|
Professional
|
Both
|
$1,114.89
|
|
|
Service Code
|
HCPCS 28160
|
| Min. Negotiated Rate |
$216.52 |
| Max. Negotiated Rate |
$695.95 |
| Rate for Payer: Cash Price |
$309.74
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$309.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$278.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$278.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$293.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$309.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$293.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$309.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$309.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$231.98
|
| Rate for Payer: Healthfirst Commercial |
$309.31
|
| Rate for Payer: Healthfirst Essential Plan |
$695.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$293.84
|
| Rate for Payer: Healthfirst QHP |
$309.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$216.52
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$309.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$262.91
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$216.52
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$309.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$231.98
|
| Rate for Payer: SOMOS Essential |
$231.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$309.31
|
|
|
PR HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION
|
Professional
|
Both
|
$288.93
|
|
|
Service Code
|
HCPCS 90935
|
| Min. Negotiated Rate |
$34.06 |
| Max. Negotiated Rate |
$173.00 |
| Rate for Payer: Amida Care Medicaid |
$34.06
|
| Rate for Payer: Cash Price |
$78.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$76.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$69.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$69.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$73.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$76.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$73.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$76.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$76.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$57.67
|
| Rate for Payer: Healthfirst Commercial |
$76.89
|
| Rate for Payer: Healthfirst Essential Plan |
$173.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$73.05
|
| Rate for Payer: Healthfirst QHP |
$76.89
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$53.82
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$76.89
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$65.36
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$53.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$76.89
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$57.67
|
| Rate for Payer: SOMOS Essential |
$57.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$76.89
|
|
|
PR HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX
|
Professional
|
Both
|
$407.79
|
|
|
Service Code
|
HCPCS 90937
|
| Min. Negotiated Rate |
$55.62 |
| Max. Negotiated Rate |
$251.50 |
| Rate for Payer: Amida Care Medicaid |
$55.62
|
| Rate for Payer: Cash Price |
$112.36
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$111.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$100.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$100.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$106.19
|
| Rate for Payer: Fidelis Medicare Advantage |
$111.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$106.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$111.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$83.83
|
| Rate for Payer: Healthfirst Commercial |
$111.78
|
| Rate for Payer: Healthfirst Essential Plan |
$251.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$106.19
|
| Rate for Payer: Healthfirst QHP |
$111.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$78.25
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$111.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$95.01
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$78.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$111.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$83.83
|
| Rate for Payer: SOMOS Essential |
$83.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$111.78
|
|
|
PR HEMOPERFUSION
|
Professional
|
Both
|
$352.56
|
|
|
Service Code
|
HCPCS 90997
|
| Min. Negotiated Rate |
$67.49 |
| Max. Negotiated Rate |
$216.94 |
| Rate for Payer: Cash Price |
$96.59
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$96.42
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$86.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$86.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$91.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$96.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$91.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$96.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$96.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$72.31
|
| Rate for Payer: Healthfirst Commercial |
$96.42
|
| Rate for Payer: Healthfirst Essential Plan |
$216.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$91.60
|
| Rate for Payer: Healthfirst QHP |
$96.42
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$67.49
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$96.42
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$81.96
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$67.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$96.42
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$72.31
|
| Rate for Payer: SOMOS Essential |
$72.31
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$96.42
|
|
|
PR HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Professional
|
Both
|
$831.22
|
|
|
Service Code
|
HCPCS 46221
|
| Min. Negotiated Rate |
$158.62 |
| Max. Negotiated Rate |
$509.85 |
| Rate for Payer: Cash Price |
$225.62
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$226.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$203.94
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$203.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$215.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$226.60
|
| Rate for Payer: Fidelis Qualified Health Plan |
$215.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$226.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$226.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$169.95
|
| Rate for Payer: Healthfirst Commercial |
$226.60
|
| Rate for Payer: Healthfirst Essential Plan |
$509.85
|
| Rate for Payer: Healthfirst Medicare Advantage |
$215.27
|
| Rate for Payer: Healthfirst QHP |
$226.60
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$158.62
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$226.60
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$192.61
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$158.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$226.60
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$169.95
|
| Rate for Payer: SOMOS Essential |
$169.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$226.60
|
|
|
PR HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO
|
Professional
|
Both
|
$2,125.80
|
|
|
Service Code
|
HCPCS 46260
|
| Min. Negotiated Rate |
$399.23 |
| Max. Negotiated Rate |
$1,283.24 |
| Rate for Payer: Cash Price |
$573.32
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$570.33
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$513.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$513.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$541.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$570.33
|
| Rate for Payer: Fidelis Qualified Health Plan |
$541.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$570.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$570.33
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$427.75
|
| Rate for Payer: Healthfirst Commercial |
$570.33
|
| Rate for Payer: Healthfirst Essential Plan |
$1,283.24
|
| Rate for Payer: Healthfirst Medicare Advantage |
$541.81
|
| Rate for Payer: Healthfirst QHP |
$570.33
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$399.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$570.33
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$484.78
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$399.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$570.33
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$427.75
|
| Rate for Payer: SOMOS Essential |
$427.75
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$570.33
|
|
|
PR HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP
|
Professional
|
Both
|
$1,560.23
|
|
|
Service Code
|
HCPCS 46255
|
| Min. Negotiated Rate |
$292.18 |
| Max. Negotiated Rate |
$939.15 |
| Rate for Payer: Cash Price |
$420.95
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$417.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$375.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$375.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$396.53
|
| Rate for Payer: Fidelis Medicare Advantage |
$417.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$396.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$417.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$417.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$313.05
|
| Rate for Payer: Healthfirst Commercial |
$417.40
|
| Rate for Payer: Healthfirst Essential Plan |
$939.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$396.53
|
| Rate for Payer: Healthfirst QHP |
$417.40
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$292.18
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$417.40
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$354.79
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$292.18
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$417.40
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$313.05
|
| Rate for Payer: SOMOS Essential |
$313.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$417.40
|
|
|
PR HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP
|
Professional
|
Both
|
$1,401.09
|
|
|
Service Code
|
HCPCS 46250
|
| Min. Negotiated Rate |
$265.40 |
| Max. Negotiated Rate |
$853.07 |
| Rate for Payer: Cash Price |
$378.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$379.14
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$341.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$341.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$360.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$379.14
|
| Rate for Payer: Fidelis Qualified Health Plan |
$360.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$379.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$379.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$284.36
|
| Rate for Payer: Healthfirst Commercial |
$379.14
|
| Rate for Payer: Healthfirst Essential Plan |
$853.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$360.18
|
| Rate for Payer: Healthfirst QHP |
$379.14
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$265.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$379.14
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$322.27
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$265.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$379.14
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$284.36
|
| Rate for Payer: SOMOS Essential |
$284.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$379.14
|
|
|
PR HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO
|
Professional
|
Both
|
$1,786.26
|
|
|
Service Code
|
HCPCS 46257
|
| Min. Negotiated Rate |
$340.19 |
| Max. Negotiated Rate |
$1,093.45 |
| Rate for Payer: Cash Price |
$487.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$485.98
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$437.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$437.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$461.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$485.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$461.68
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$485.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$485.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$364.49
|
| Rate for Payer: Healthfirst Commercial |
$485.98
|
| Rate for Payer: Healthfirst Essential Plan |
$1,093.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$461.68
|
| Rate for Payer: Healthfirst QHP |
$485.98
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$340.19
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$485.98
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$413.08
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$340.19
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$485.98
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$364.49
|
| Rate for Payer: SOMOS Essential |
$364.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$485.98
|
|
|
PR HEMORRHOIDOPEXY STAPLING
|
Professional
|
Both
|
$1,729.04
|
|
|
Service Code
|
HCPCS 46947
|
| Min. Negotiated Rate |
$322.97 |
| Max. Negotiated Rate |
$1,038.13 |
| Rate for Payer: Cash Price |
$466.65
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$461.39
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$415.25
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$415.25
|
| Rate for Payer: Fidelis Essential Plan QHP |
$438.32
|
| Rate for Payer: Fidelis Medicare Advantage |
$461.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$438.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$461.39
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$461.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$346.04
|
| Rate for Payer: Healthfirst Commercial |
$461.39
|
| Rate for Payer: Healthfirst Essential Plan |
$1,038.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$438.32
|
| Rate for Payer: Healthfirst QHP |
$461.39
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$322.97
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$461.39
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$392.18
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$322.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$461.39
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$346.04
|
| Rate for Payer: SOMOS Essential |
$346.04
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$461.39
|
|
|
PR HEPATCOTOMY/HEPATCOSTOMY W/EXPL DRG/RMVL ST1
|
Professional
|
Both
|
$9,723.32
|
|
|
Service Code
|
HCPCS 47400
|
| Min. Negotiated Rate |
$1,792.26 |
| Max. Negotiated Rate |
$5,760.83 |
| Rate for Payer: Cash Price |
$2,585.21
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,560.37
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,304.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,304.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,432.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,560.37
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,432.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,560.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,560.37
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,920.28
|
| Rate for Payer: Healthfirst Commercial |
$2,560.37
|
| Rate for Payer: Healthfirst Essential Plan |
$5,760.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,432.35
|
| Rate for Payer: Healthfirst QHP |
$2,560.37
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,792.26
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,560.37
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,176.31
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,792.26
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,560.37
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,920.28
|
| Rate for Payer: SOMOS Essential |
$1,920.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,560.37
|
|
|
PR HEPATECTOMY RESCJ PARTIAL LOBECTOMY
|
Professional
|
Both
|
$10,512.08
|
|
|
Service Code
|
HCPCS 47120
|
| Min. Negotiated Rate |
$1,941.91 |
| Max. Negotiated Rate |
$6,241.86 |
| Rate for Payer: Cash Price |
$2,799.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,774.16
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,496.74
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,496.74
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,635.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,774.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,635.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,774.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,774.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,080.62
|
| Rate for Payer: Healthfirst Commercial |
$2,774.16
|
| Rate for Payer: Healthfirst Essential Plan |
$6,241.86
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,635.45
|
| Rate for Payer: Healthfirst QHP |
$2,774.16
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,941.91
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,774.16
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,358.04
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,941.91
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,774.16
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,080.62
|
| Rate for Payer: SOMOS Essential |
$2,080.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,774.16
|
|
|
PR HEPATECTOMY RESCJ TOTAL LEFT LOBECTOMY
|
Professional
|
Both
|
$13,863.08
|
|
|
Service Code
|
HCPCS 47125
|
| Min. Negotiated Rate |
$2,560.54 |
| Max. Negotiated Rate |
$8,230.30 |
| Rate for Payer: Cash Price |
$3,687.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,657.91
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,292.12
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,292.12
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,475.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,657.91
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,475.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,657.91
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,657.91
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,743.43
|
| Rate for Payer: Healthfirst Commercial |
$3,657.91
|
| Rate for Payer: Healthfirst Essential Plan |
$8,230.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,475.01
|
| Rate for Payer: Healthfirst QHP |
$3,657.91
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,560.54
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,657.91
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$3,109.22
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,560.54
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,657.91
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,743.43
|
| Rate for Payer: SOMOS Essential |
$2,743.43
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,657.91
|
|
|
PR HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY
|
Professional
|
Both
|
$14,892.08
|
|
|
Service Code
|
HCPCS 47130
|
| Min. Negotiated Rate |
$2,745.23 |
| Max. Negotiated Rate |
$8,823.96 |
| Rate for Payer: Cash Price |
$3,957.67
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,921.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,529.58
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,529.58
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,725.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,921.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,725.67
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,921.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,921.76
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,941.32
|
| Rate for Payer: Healthfirst Commercial |
$3,921.76
|
| Rate for Payer: Healthfirst Essential Plan |
$8,823.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,725.67
|
| Rate for Payer: Healthfirst QHP |
$3,921.76
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,745.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,921.76
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$3,333.50
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,745.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,921.76
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,941.32
|
| Rate for Payer: SOMOS Essential |
$2,941.32
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,921.76
|
|
|
PR HEPATECTOMY RESCJ TRISEGMENTECTOMY
|
Professional
|
Both
|
$15,391.67
|
|
|
Service Code
|
HCPCS 47122
|
| Min. Negotiated Rate |
$2,854.94 |
| Max. Negotiated Rate |
$9,176.58 |
| Rate for Payer: Cash Price |
$4,087.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,078.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,670.63
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,670.63
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,874.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,078.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,874.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,078.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,078.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3,058.86
|
| Rate for Payer: Healthfirst Commercial |
$4,078.48
|
| Rate for Payer: Healthfirst Essential Plan |
$9,176.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,874.56
|
| Rate for Payer: Healthfirst QHP |
$4,078.48
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,854.94
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$4,078.48
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$3,466.71
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,854.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,078.48
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3,058.86
|
| Rate for Payer: SOMOS Essential |
$3,058.86
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,078.48
|
|
|
PR HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES
|
Professional
|
Both
|
$5,462.38
|
|
|
Service Code
|
HCPCS 47010
|
| Min. Negotiated Rate |
$1,013.85 |
| Max. Negotiated Rate |
$3,258.79 |
| Rate for Payer: Cash Price |
$1,458.21
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,448.35
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,303.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,303.52
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,375.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,448.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,375.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,448.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,448.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,086.26
|
| Rate for Payer: Healthfirst Commercial |
$1,448.35
|
| Rate for Payer: Healthfirst Essential Plan |
$3,258.79
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,375.93
|
| Rate for Payer: Healthfirst QHP |
$1,448.35
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,013.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,448.35
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,231.10
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,013.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,448.35
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,086.26
|
| Rate for Payer: SOMOS Essential |
$1,086.26
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,448.35
|
|
