|
PR INCISIONAL BIOPSY EYELID SKIN & LID MARGIN
|
Professional
|
Both
|
$281.40
|
|
|
Service Code
|
HCPCS 67810
|
| Min. Negotiated Rate |
$53.75 |
| Max. Negotiated Rate |
$172.78 |
| Rate for Payer: Cash Price |
$76.32
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$76.79
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$69.11
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$69.11
|
| Rate for Payer: Fidelis Essential Plan QHP |
$72.95
|
| Rate for Payer: Fidelis Medicare Advantage |
$76.79
|
| Rate for Payer: Fidelis Qualified Health Plan |
$72.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$76.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$76.79
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$57.59
|
| Rate for Payer: Healthfirst Commercial |
$76.79
|
| Rate for Payer: Healthfirst Essential Plan |
$172.78
|
| Rate for Payer: Healthfirst Medicare Advantage |
$72.95
|
| Rate for Payer: Healthfirst QHP |
$76.79
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$53.75
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$76.79
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$65.27
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$53.75
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$76.79
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$57.59
|
| Rate for Payer: SOMOS Essential |
$57.59
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$76.79
|
|
|
PR INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION
|
Professional
|
Both
|
$129.92
|
|
|
Service Code
|
HCPCS 11107
|
| Min. Negotiated Rate |
$24.04 |
| Max. Negotiated Rate |
$77.27 |
| Rate for Payer: Cash Price |
$35.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$34.34
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$30.91
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$30.91
|
| Rate for Payer: Fidelis Essential Plan QHP |
$32.62
|
| Rate for Payer: Fidelis Medicare Advantage |
$34.34
|
| Rate for Payer: Fidelis Qualified Health Plan |
$32.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34.34
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$34.34
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25.75
|
| Rate for Payer: Healthfirst Commercial |
$34.34
|
| Rate for Payer: Healthfirst Essential Plan |
$77.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$32.62
|
| Rate for Payer: Healthfirst QHP |
$34.34
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$24.04
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$34.34
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$29.19
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$24.04
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$34.34
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$25.75
|
| Rate for Payer: SOMOS Essential |
$25.75
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$34.34
|
|
|
PR INCISIONAL BIOPSY SKIN SINGLE LESION
|
Professional
|
Both
|
$236.95
|
|
|
Service Code
|
HCPCS 11106
|
| Min. Negotiated Rate |
$44.93 |
| Max. Negotiated Rate |
$144.41 |
| Rate for Payer: Cash Price |
$64.57
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$64.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$57.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$57.76
|
| Rate for Payer: Fidelis Essential Plan QHP |
$60.97
|
| Rate for Payer: Fidelis Medicare Advantage |
$64.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$60.97
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$64.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$64.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$48.13
|
| Rate for Payer: Healthfirst Commercial |
$64.18
|
| Rate for Payer: Healthfirst Essential Plan |
$144.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$60.97
|
| Rate for Payer: Healthfirst QHP |
$64.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$44.93
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$64.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$54.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$44.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$64.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$48.13
|
| Rate for Payer: SOMOS Essential |
$48.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$64.18
|
|
|
PR INCISION ANAL SEPTUM INFANT
|
Professional
|
Both
|
$1,217.90
|
|
|
Service Code
|
HCPCS 46070
|
| Min. Negotiated Rate |
$229.51 |
| Max. Negotiated Rate |
$737.71 |
| Rate for Payer: Cash Price |
$327.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$327.87
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$295.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$295.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$311.48
|
| Rate for Payer: Fidelis Medicare Advantage |
$327.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$311.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$327.87
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$327.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$245.90
|
| Rate for Payer: Healthfirst Commercial |
$327.87
|
| Rate for Payer: Healthfirst Essential Plan |
$737.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$311.48
|
| Rate for Payer: Healthfirst QHP |
$327.87
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$229.51
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$327.87
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$278.69
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$229.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$327.87
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$245.90
|
| Rate for Payer: SOMOS Essential |
$245.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$327.87
|
|
|
PR INCISION AND DRAINAGE APPENDICEAL ABSCESS OPEN
|
Professional
|
Both
|
$3,558.66
|
|
|
Service Code
|
HCPCS 44900
|
| Min. Negotiated Rate |
$658.13 |
| Max. Negotiated Rate |
$2,115.43 |
| Rate for Payer: Cash Price |
$947.34
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$940.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$846.17
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$846.17
|
| Rate for Payer: Fidelis Essential Plan QHP |
$893.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$940.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$893.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$940.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$940.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$705.14
|
| Rate for Payer: Healthfirst Commercial |
$940.19
|
| Rate for Payer: Healthfirst Essential Plan |
$2,115.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$893.18
|
| Rate for Payer: Healthfirst QHP |
$940.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$658.13
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$940.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$799.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$658.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$940.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$705.14
|
| Rate for Payer: SOMOS Essential |
$705.14
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$940.19
|
|
|
PR INCISION BONE CORTEX FOOT
|
Professional
|
Both
|
$2,384.80
|
|
|
Service Code
|
HCPCS 28005
|
| Min. Negotiated Rate |
$457.49 |
| Max. Negotiated Rate |
$1,470.49 |
| Rate for Payer: Cash Price |
$656.48
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$653.55
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$588.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$588.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$620.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$653.55
|
| Rate for Payer: Fidelis Qualified Health Plan |
$620.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$653.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$653.55
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$490.16
|
| Rate for Payer: Healthfirst Commercial |
$653.55
|
| Rate for Payer: Healthfirst Essential Plan |
$1,470.49
|
| Rate for Payer: Healthfirst Medicare Advantage |
$620.87
|
| Rate for Payer: Healthfirst QHP |
$653.55
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$457.49
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$653.55
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$555.52
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$457.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$653.55
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$490.16
|
| Rate for Payer: SOMOS Essential |
$490.16
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$653.55
|
|
|
PR INCISION BONE CORTEX HAND/FINGER
|
Professional
|
Both
|
$2,440.27
|
|
|
Service Code
|
HCPCS 26034
|
| Min. Negotiated Rate |
$464.10 |
| Max. Negotiated Rate |
$1,491.75 |
| Rate for Payer: Cash Price |
$663.29
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$663.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$596.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$596.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$629.85
|
| Rate for Payer: Fidelis Medicare Advantage |
$663.00
|
| Rate for Payer: Fidelis Qualified Health Plan |
$629.85
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$663.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$663.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$497.25
|
| Rate for Payer: Healthfirst Commercial |
$663.00
|
| Rate for Payer: Healthfirst Essential Plan |
$1,491.75
|
| Rate for Payer: Healthfirst Medicare Advantage |
$629.85
|
| Rate for Payer: Healthfirst QHP |
$663.00
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$464.10
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$663.00
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$563.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$464.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$663.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$497.25
|
| Rate for Payer: SOMOS Essential |
$497.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$663.00
|
|
|
PR INCISION BONE CORTEX PELVIS&/HIP JOINT
|
Professional
|
Both
|
$4,460.75
|
|
|
Service Code
|
HCPCS 26992
|
| Min. Negotiated Rate |
$832.55 |
| Max. Negotiated Rate |
$2,676.06 |
| Rate for Payer: Cash Price |
$1,206.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,189.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,070.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,070.42
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,129.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,189.36
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,129.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,189.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,189.36
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$892.02
|
| Rate for Payer: Healthfirst Commercial |
$1,189.36
|
| Rate for Payer: Healthfirst Essential Plan |
$2,676.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,129.89
|
| Rate for Payer: Healthfirst QHP |
$1,189.36
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$832.55
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,189.36
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,010.96
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$832.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,189.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$892.02
|
| Rate for Payer: SOMOS Essential |
$892.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,189.36
|
|
|
PR INCISION BONE CORTEX SHOULDER AREA
|
Professional
|
Both
|
$3,027.85
|
|
|
Service Code
|
HCPCS 23035
|
| Min. Negotiated Rate |
$569.76 |
| Max. Negotiated Rate |
$1,831.37 |
| Rate for Payer: Cash Price |
$812.64
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$813.94
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$732.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$732.55
|
| Rate for Payer: Fidelis Essential Plan QHP |
$773.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$813.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$773.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$813.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$813.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$610.46
|
| Rate for Payer: Healthfirst Commercial |
$813.94
|
| Rate for Payer: Healthfirst Essential Plan |
$1,831.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$773.24
|
| Rate for Payer: Healthfirst QHP |
$813.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$569.76
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$813.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$691.85
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$569.76
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$813.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$610.46
|
| Rate for Payer: SOMOS Essential |
$610.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$813.94
|
|
|
PR INCISION CONJUNCTIVA DRAINAGE OF CYST
|
Professional
|
Both
|
$453.92
|
|
|
Service Code
|
HCPCS 68020
|
| Min. Negotiated Rate |
$86.39 |
| Max. Negotiated Rate |
$277.67 |
| Rate for Payer: Cash Price |
$124.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$123.41
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$111.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$111.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$117.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$123.41
|
| Rate for Payer: Fidelis Qualified Health Plan |
$117.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$123.41
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$123.41
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$92.56
|
| Rate for Payer: Healthfirst Commercial |
$123.41
|
| Rate for Payer: Healthfirst Essential Plan |
$277.67
|
| Rate for Payer: Healthfirst Medicare Advantage |
$117.24
|
| Rate for Payer: Healthfirst QHP |
$123.41
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$86.39
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$123.41
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$104.90
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$86.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$123.41
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$92.56
|
| Rate for Payer: SOMOS Essential |
$92.56
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$123.41
|
|
|
PR INCISION DEEP BONE CORTEX FOREARM&/WRIST
|
Professional
|
Both
|
$2,596.90
|
|
|
Service Code
|
HCPCS 25035
|
| Min. Negotiated Rate |
$495.97 |
| Max. Negotiated Rate |
$1,594.19 |
| Rate for Payer: Cash Price |
$711.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$708.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$637.68
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$637.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$673.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$708.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$673.10
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$708.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$708.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$531.40
|
| Rate for Payer: Healthfirst Commercial |
$708.53
|
| Rate for Payer: Healthfirst Essential Plan |
$1,594.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$673.10
|
| Rate for Payer: Healthfirst QHP |
$708.53
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$495.97
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$708.53
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$602.25
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$495.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$708.53
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$531.40
|
| Rate for Payer: SOMOS Essential |
$531.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$708.53
|
|
|
PR INCISION DEEP OPENING BONE CORTEX THORAX
|
Professional
|
Both
|
$2,029.34
|
|
|
Service Code
|
HCPCS 21510
|
| Min. Negotiated Rate |
$378.85 |
| Max. Negotiated Rate |
$1,217.72 |
| Rate for Payer: Cash Price |
$545.74
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$541.21
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$487.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$487.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$514.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$541.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$514.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$541.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$541.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$405.91
|
| Rate for Payer: Healthfirst Commercial |
$541.21
|
| Rate for Payer: Healthfirst Essential Plan |
$1,217.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$514.15
|
| Rate for Payer: Healthfirst QHP |
$541.21
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$378.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$541.21
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$460.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$378.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$541.21
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$405.91
|
| Rate for Payer: SOMOS Essential |
$405.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$541.21
|
|
|
PR INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE
|
Professional
|
Both
|
$779.94
|
|
|
Service Code
|
HCPCS 10061
|
| Min. Negotiated Rate |
$148.41 |
| Max. Negotiated Rate |
$477.05 |
| Rate for Payer: Cash Price |
$215.09
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$212.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$190.82
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$190.82
|
| Rate for Payer: Fidelis Essential Plan QHP |
$201.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$212.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$201.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$212.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$212.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$159.01
|
| Rate for Payer: Healthfirst Commercial |
$212.02
|
| Rate for Payer: Healthfirst Essential Plan |
$477.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$201.42
|
| Rate for Payer: Healthfirst QHP |
$212.02
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$148.41
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$212.02
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$180.22
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$148.41
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$212.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$159.01
|
| Rate for Payer: SOMOS Essential |
$159.01
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$212.02
|
|
|
PR INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE
|
Professional
|
Both
|
$444.40
|
|
|
Service Code
|
HCPCS 10060
|
| Min. Negotiated Rate |
$86.40 |
| Max. Negotiated Rate |
$277.72 |
| Rate for Payer: Cash Price |
$124.16
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$123.43
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$111.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$111.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$117.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$123.43
|
| Rate for Payer: Fidelis Qualified Health Plan |
$117.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$123.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$123.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$92.57
|
| Rate for Payer: Healthfirst Commercial |
$123.43
|
| Rate for Payer: Healthfirst Essential Plan |
$277.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$117.26
|
| Rate for Payer: Healthfirst QHP |
$123.43
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$86.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$123.43
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$104.92
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$86.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$123.43
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$92.57
|
| Rate for Payer: SOMOS Essential |
$92.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$123.43
|
|
|
PR INCISION&DRAINAGE BURSA FOOT
|
Professional
|
Both
|
$396.06
|
|
|
Service Code
|
HCPCS 28001
|
| Min. Negotiated Rate |
$74.72 |
| Max. Negotiated Rate |
$240.16 |
| Rate for Payer: Cash Price |
$107.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$106.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$96.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$96.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$101.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$106.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$101.40
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$106.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$106.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$80.06
|
| Rate for Payer: Healthfirst Commercial |
$106.74
|
| Rate for Payer: Healthfirst Essential Plan |
$240.16
|
| Rate for Payer: Healthfirst Medicare Advantage |
$101.40
|
| Rate for Payer: Healthfirst QHP |
$106.74
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$74.72
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$106.74
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$90.73
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$74.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$106.74
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$80.06
|
| Rate for Payer: SOMOS Essential |
$80.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$106.74
|
|
|
PR INCISION & DRAINAGE COMPLEX PO WOUND INFECTION
|
Professional
|
Both
|
$791.32
|
|
|
Service Code
|
HCPCS 10180
|
| Min. Negotiated Rate |
$149.15 |
| Max. Negotiated Rate |
$479.41 |
| Rate for Payer: Cash Price |
$213.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$213.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$191.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$191.76
|
| Rate for Payer: Fidelis Essential Plan QHP |
$202.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$213.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$202.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$213.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$213.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$159.80
|
| Rate for Payer: Healthfirst Commercial |
$213.07
|
| Rate for Payer: Healthfirst Essential Plan |
$479.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$202.42
|
| Rate for Payer: Healthfirst QHP |
$213.07
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$149.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$213.07
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$181.11
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$149.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$213.07
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$159.80
|
| Rate for Payer: SOMOS Essential |
$159.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$213.07
|
|
|
PR INCISION & DRAINAGE FOREARM&/WRIST BURSA
|
Professional
|
Both
|
$1,641.57
|
|
|
Service Code
|
HCPCS 25031
|
| Min. Negotiated Rate |
$312.63 |
| Max. Negotiated Rate |
$1,004.89 |
| Rate for Payer: Cash Price |
$447.63
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$446.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$401.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$401.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$424.29
|
| Rate for Payer: Fidelis Medicare Advantage |
$446.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$424.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$446.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$446.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$334.96
|
| Rate for Payer: Healthfirst Commercial |
$446.62
|
| Rate for Payer: Healthfirst Essential Plan |
$1,004.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$424.29
|
| Rate for Payer: Healthfirst QHP |
$446.62
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$312.63
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$446.62
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$379.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$312.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$446.62
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$334.96
|
| Rate for Payer: SOMOS Essential |
$334.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$446.62
|
|
|
PR INCISION DRAINAGE LACRIMAL GLAND
|
Professional
|
Both
|
$540.86
|
|
|
Service Code
|
HCPCS 68400
|
| Min. Negotiated Rate |
$103.88 |
| Max. Negotiated Rate |
$333.90 |
| Rate for Payer: Cash Price |
$149.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$148.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$133.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$133.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$140.98
|
| Rate for Payer: Fidelis Medicare Advantage |
$148.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$140.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$148.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$148.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$111.30
|
| Rate for Payer: Healthfirst Commercial |
$148.40
|
| Rate for Payer: Healthfirst Essential Plan |
$333.90
|
| Rate for Payer: Healthfirst Medicare Advantage |
$140.98
|
| Rate for Payer: Healthfirst QHP |
$148.40
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$103.88
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$148.40
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$126.14
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$103.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$148.40
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$111.30
|
| Rate for Payer: SOMOS Essential |
$111.30
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$148.40
|
|
|
PR INCISION DRAINAGE LACRIMAL SAC
|
Professional
|
Both
|
$684.15
|
|
|
Service Code
|
HCPCS 68420
|
| Min. Negotiated Rate |
$130.21 |
| Max. Negotiated Rate |
$418.55 |
| Rate for Payer: Cash Price |
$188.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$186.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$167.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$167.42
|
| Rate for Payer: Fidelis Essential Plan QHP |
$176.72
|
| Rate for Payer: Fidelis Medicare Advantage |
$186.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$176.72
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$186.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$186.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$139.51
|
| Rate for Payer: Healthfirst Commercial |
$186.02
|
| Rate for Payer: Healthfirst Essential Plan |
$418.55
|
| Rate for Payer: Healthfirst Medicare Advantage |
$176.72
|
| Rate for Payer: Healthfirst QHP |
$186.02
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$130.21
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$186.02
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$158.12
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$130.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$186.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$139.51
|
| Rate for Payer: SOMOS Essential |
$139.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$186.02
|
|
|
PR INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA
|
Professional
|
Both
|
$1,721.13
|
|
|
Service Code
|
HCPCS 27603
|
| Min. Negotiated Rate |
$320.05 |
| Max. Negotiated Rate |
$1,028.72 |
| Rate for Payer: Cash Price |
$463.44
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$457.21
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$411.49
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$411.49
|
| Rate for Payer: Fidelis Essential Plan QHP |
$434.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$457.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$434.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$457.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$457.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$342.91
|
| Rate for Payer: Healthfirst Commercial |
$457.21
|
| Rate for Payer: Healthfirst Essential Plan |
$1,028.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$434.35
|
| Rate for Payer: Healthfirst QHP |
$457.21
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$320.05
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$457.21
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$388.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$320.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$457.21
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$342.91
|
| Rate for Payer: SOMOS Essential |
$342.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$457.21
|
|
|
PR INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA
|
Professional
|
Both
|
$1,394.75
|
|
|
Service Code
|
HCPCS 27604
|
| Min. Negotiated Rate |
$275.06 |
| Max. Negotiated Rate |
$884.14 |
| Rate for Payer: Cash Price |
$381.31
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$392.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$353.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$353.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$373.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$392.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$373.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$392.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$392.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$294.71
|
| Rate for Payer: Healthfirst Commercial |
$392.95
|
| Rate for Payer: Healthfirst Essential Plan |
$884.14
|
| Rate for Payer: Healthfirst Medicare Advantage |
$373.30
|
| Rate for Payer: Healthfirst QHP |
$392.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$275.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$392.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$334.01
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$275.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$392.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$294.71
|
| Rate for Payer: SOMOS Essential |
$294.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$392.95
|
|
|
PR INCISION & DRAINAGE PILONIDAL CYST COMPLICATED
|
Professional
|
Both
|
$744.00
|
|
|
Service Code
|
HCPCS 10081
|
| Min. Negotiated Rate |
$141.16 |
| Max. Negotiated Rate |
$453.71 |
| Rate for Payer: Cash Price |
$202.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$201.65
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$181.49
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$181.49
|
| Rate for Payer: Fidelis Essential Plan QHP |
$191.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$201.65
|
| Rate for Payer: Fidelis Qualified Health Plan |
$191.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$201.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$201.65
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$151.24
|
| Rate for Payer: Healthfirst Commercial |
$201.65
|
| Rate for Payer: Healthfirst Essential Plan |
$453.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$191.57
|
| Rate for Payer: Healthfirst QHP |
$201.65
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$141.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$201.65
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$171.40
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$141.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$201.65
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$151.24
|
| Rate for Payer: SOMOS Essential |
$151.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$201.65
|
|
|
PR INCISION & DRAINAGE PILONIDAL CYST SIMPLE
|
Professional
|
Both
|
$450.59
|
|
|
Service Code
|
HCPCS 10080
|
| Min. Negotiated Rate |
$86.16 |
| Max. Negotiated Rate |
$276.95 |
| Rate for Payer: Cash Price |
$124.22
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$123.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$110.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$110.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$116.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$123.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$116.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$123.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$123.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$92.32
|
| Rate for Payer: Healthfirst Commercial |
$123.09
|
| Rate for Payer: Healthfirst Essential Plan |
$276.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$116.94
|
| Rate for Payer: Healthfirst QHP |
$123.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$86.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$123.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$104.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$86.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$123.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$92.32
|
| Rate for Payer: SOMOS Essential |
$92.32
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$123.09
|
|
|
PR INCISION&DRAINAGE UPPER ARM/ELBOW BURSA
|
Professional
|
Both
|
$710.05
|
|
|
Service Code
|
HCPCS 23931
|
| Min. Negotiated Rate |
$134.23 |
| Max. Negotiated Rate |
$431.46 |
| Rate for Payer: Cash Price |
$193.34
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$191.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$172.58
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$172.58
|
| Rate for Payer: Fidelis Essential Plan QHP |
$182.17
|
| Rate for Payer: Fidelis Medicare Advantage |
$191.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$182.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$191.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$191.76
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$143.82
|
| Rate for Payer: Healthfirst Commercial |
$191.76
|
| Rate for Payer: Healthfirst Essential Plan |
$431.46
|
| Rate for Payer: Healthfirst Medicare Advantage |
$182.17
|
| Rate for Payer: Healthfirst QHP |
$191.76
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$134.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$191.76
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$163.00
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$134.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$191.76
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$143.82
|
| Rate for Payer: SOMOS Essential |
$143.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$191.76
|
|
|
PR INCISION EXTENSOR TENDON SHEATH WRIST
|
Professional
|
Both
|
$1,533.70
|
|
|
Service Code
|
HCPCS 25000
|
| Min. Negotiated Rate |
$292.95 |
| Max. Negotiated Rate |
$941.62 |
| Rate for Payer: Cash Price |
$419.79
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$418.50
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$376.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$376.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$397.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$418.50
|
| Rate for Payer: Fidelis Qualified Health Plan |
$397.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$418.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$418.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$313.88
|
| Rate for Payer: Healthfirst Commercial |
$418.50
|
| Rate for Payer: Healthfirst Essential Plan |
$941.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$397.57
|
| Rate for Payer: Healthfirst QHP |
$418.50
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$292.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$418.50
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$355.73
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$292.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$418.50
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$313.88
|
| Rate for Payer: SOMOS Essential |
$313.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$418.50
|
|
