|
PR INSERTION UTERINE TANDEM&/VAGINAL OVOIDS
|
Professional
|
Both
|
$1,175.09
|
|
|
Service Code
|
HCPCS 57155
|
| Min. Negotiated Rate |
$227.02 |
| Max. Negotiated Rate |
$729.70 |
| Rate for Payer: Cash Price |
$320.92
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$324.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$291.88
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$291.88
|
| Rate for Payer: Fidelis Essential Plan QHP |
$308.09
|
| Rate for Payer: Fidelis Medicare Advantage |
$324.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$308.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$324.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$324.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$243.23
|
| Rate for Payer: Healthfirst Commercial |
$324.31
|
| Rate for Payer: Healthfirst Essential Plan |
$729.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$308.09
|
| Rate for Payer: Healthfirst QHP |
$324.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$227.02
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$324.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$275.66
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$227.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$324.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$243.23
|
| Rate for Payer: SOMOS Essential |
$243.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$324.31
|
|
|
PR INSERTION VAGINAL RADIATION DEVICE
|
Professional
|
Both
|
$627.10
|
|
|
Service Code
|
HCPCS 57156
|
| Min. Negotiated Rate |
$119.88 |
| Max. Negotiated Rate |
$385.31 |
| Rate for Payer: Cash Price |
$170.84
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$171.25
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$154.12
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$154.12
|
| Rate for Payer: Fidelis Essential Plan QHP |
$162.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$171.25
|
| Rate for Payer: Fidelis Qualified Health Plan |
$162.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$171.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$171.25
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$128.44
|
| Rate for Payer: Healthfirst Commercial |
$171.25
|
| Rate for Payer: Healthfirst Essential Plan |
$385.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$162.69
|
| Rate for Payer: Healthfirst QHP |
$171.25
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$119.88
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$171.25
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$145.56
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$119.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$171.25
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$128.44
|
| Rate for Payer: SOMOS Essential |
$128.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$171.25
|
|
|
PR INSERTION VASCULAR PEDICLE CARPAL BONE
|
Professional
|
Both
|
$3,251.75
|
|
|
Service Code
|
HCPCS 25430
|
| Min. Negotiated Rate |
$614.36 |
| Max. Negotiated Rate |
$1,974.73 |
| Rate for Payer: Cash Price |
$880.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$877.66
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$789.89
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$789.89
|
| Rate for Payer: Fidelis Essential Plan QHP |
$833.78
|
| Rate for Payer: Fidelis Medicare Advantage |
$877.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$833.78
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$877.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$877.66
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$658.25
|
| Rate for Payer: Healthfirst Commercial |
$877.66
|
| Rate for Payer: Healthfirst Essential Plan |
$1,974.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$833.78
|
| Rate for Payer: Healthfirst QHP |
$877.66
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$614.36
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$877.66
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$746.01
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$614.36
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$877.66
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$658.25
|
| Rate for Payer: SOMOS Essential |
$658.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$877.66
|
|
|
PR INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX
|
Professional
|
Both
|
$707.63
|
|
|
Service Code
|
HCPCS 20650
|
| Min. Negotiated Rate |
$138.81 |
| Max. Negotiated Rate |
$446.18 |
| Rate for Payer: Cash Price |
$197.36
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$198.30
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$178.47
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$178.47
|
| Rate for Payer: Fidelis Essential Plan QHP |
$188.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$198.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$188.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$198.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$198.30
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$148.72
|
| Rate for Payer: Healthfirst Commercial |
$198.30
|
| Rate for Payer: Healthfirst Essential Plan |
$446.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$188.38
|
| Rate for Payer: Healthfirst QHP |
$198.30
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$138.81
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$198.30
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$168.56
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$138.81
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$198.30
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$148.72
|
| Rate for Payer: SOMOS Essential |
$148.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$198.30
|
|
|
PR INSERT LEFT HEART VENT BY THORACIC INC ECMO/ECLS
|
Professional
|
Both
|
$3,408.86
|
|
|
Service Code
|
HCPCS 33988
|
| Min. Negotiated Rate |
$625.50 |
| Max. Negotiated Rate |
$2,010.53 |
| Rate for Payer: Cash Price |
$901.72
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$893.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$804.21
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$804.21
|
| Rate for Payer: Fidelis Essential Plan QHP |
$848.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$893.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$848.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$893.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$893.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$670.18
|
| Rate for Payer: Healthfirst Commercial |
$893.57
|
| Rate for Payer: Healthfirst Essential Plan |
$2,010.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$848.89
|
| Rate for Payer: Healthfirst QHP |
$893.57
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$625.50
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$893.57
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$759.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$625.50
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$893.57
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$670.18
|
| Rate for Payer: SOMOS Essential |
$670.18
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$893.57
|
|
|
PR INSERT NON-TUNNEL CV CATH
|
Professional
|
Both
|
$352.70
|
|
|
Service Code
|
HCPCS 36556
|
| Min. Negotiated Rate |
$65.85 |
| Max. Negotiated Rate |
$211.66 |
| Rate for Payer: Cash Price |
$95.46
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$94.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$84.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$84.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$89.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$94.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$89.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$94.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$94.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$70.55
|
| Rate for Payer: Healthfirst Commercial |
$94.07
|
| Rate for Payer: Healthfirst Essential Plan |
$211.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$89.37
|
| Rate for Payer: Healthfirst QHP |
$94.07
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$65.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$94.07
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$79.96
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$65.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$94.07
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$70.55
|
| Rate for Payer: SOMOS Essential |
$70.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$94.07
|
|
|
PR INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT
|
Professional
|
Both
|
$339.33
|
|
|
Service Code
|
HCPCS 53855
|
| Min. Negotiated Rate |
$64.23 |
| Max. Negotiated Rate |
$206.46 |
| Rate for Payer: Cash Price |
$92.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$91.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$82.58
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$82.58
|
| Rate for Payer: Fidelis Essential Plan QHP |
$87.17
|
| Rate for Payer: Fidelis Medicare Advantage |
$91.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$87.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$91.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$91.76
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$68.82
|
| Rate for Payer: Healthfirst Commercial |
$91.76
|
| Rate for Payer: Healthfirst Essential Plan |
$206.46
|
| Rate for Payer: Healthfirst Medicare Advantage |
$87.17
|
| Rate for Payer: Healthfirst QHP |
$91.76
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$64.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$91.76
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$78.00
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$64.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$91.76
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$68.82
|
| Rate for Payer: SOMOS Essential |
$68.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$91.76
|
|
|
PR INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR
|
Professional
|
Both
|
$1,435.18
|
|
|
Service Code
|
HCPCS 36557
|
| Min. Negotiated Rate |
$268.35 |
| Max. Negotiated Rate |
$862.56 |
| Rate for Payer: Cash Price |
$384.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$383.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$345.02
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$345.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$364.19
|
| Rate for Payer: Fidelis Medicare Advantage |
$383.36
|
| Rate for Payer: Fidelis Qualified Health Plan |
$364.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$383.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$383.36
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$287.52
|
| Rate for Payer: Healthfirst Commercial |
$383.36
|
| Rate for Payer: Healthfirst Essential Plan |
$862.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$364.19
|
| Rate for Payer: Healthfirst QHP |
$383.36
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$268.35
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$383.36
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$325.86
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$268.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$383.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$287.52
|
| Rate for Payer: SOMOS Essential |
$287.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$383.36
|
|
|
PR INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I
|
Professional
|
Both
|
$929.22
|
|
|
Service Code
|
HCPCS 37191
|
| Min. Negotiated Rate |
$172.03 |
| Max. Negotiated Rate |
$552.96 |
| Rate for Payer: Cash Price |
$247.21
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$245.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$221.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$221.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$233.47
|
| Rate for Payer: Fidelis Medicare Advantage |
$245.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$233.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$245.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$245.76
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$184.32
|
| Rate for Payer: Healthfirst Commercial |
$245.76
|
| Rate for Payer: Healthfirst Essential Plan |
$552.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$233.47
|
| Rate for Payer: Healthfirst QHP |
$245.76
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$172.03
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$245.76
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$208.90
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$172.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$245.76
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$184.32
|
| Rate for Payer: SOMOS Essential |
$184.32
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$245.76
|
|
|
PR IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART
|
Professional
|
Both
|
$7,414.65
|
|
|
Service Code
|
HCPCS 35585
|
| Min. Negotiated Rate |
$1,357.98 |
| Max. Negotiated Rate |
$4,364.93 |
| Rate for Payer: Cash Price |
$1,963.72
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,939.97
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,745.97
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,745.97
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,842.97
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,939.97
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,842.97
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,939.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,939.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,454.98
|
| Rate for Payer: Healthfirst Commercial |
$1,939.97
|
| Rate for Payer: Healthfirst Essential Plan |
$4,364.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,842.97
|
| Rate for Payer: Healthfirst QHP |
$1,939.97
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,357.98
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,939.97
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,648.97
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,357.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,939.97
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,454.98
|
| Rate for Payer: SOMOS Essential |
$1,454.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,939.97
|
|
|
PR IN SITU HYBRIDIZATION 1ST PROBE STAIN
|
Professional
|
Both
|
$596.30
|
|
|
Service Code
|
HCPCS 88365 TC
|
| Min. Negotiated Rate |
$108.47 |
| Max. Negotiated Rate |
$348.64 |
| Rate for Payer: Cash Price |
$160.78
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$154.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$139.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$139.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$147.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$154.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$147.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$154.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$154.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$116.21
|
| Rate for Payer: Healthfirst Commercial |
$154.95
|
| Rate for Payer: Healthfirst Essential Plan |
$348.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$147.20
|
| Rate for Payer: Healthfirst QHP |
$154.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$108.47
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$154.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$131.71
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$108.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$154.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$116.21
|
| Rate for Payer: SOMOS Essential |
$116.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$154.95
|
|
|
PR IN SITU HYBRIDIZATION 1ST PROBE STAIN
|
Professional
|
Both
|
$164.71
|
|
|
Service Code
|
HCPCS 88365 26
|
| Min. Negotiated Rate |
$31.16 |
| Max. Negotiated Rate |
$100.17 |
| Rate for Payer: Cash Price |
$45.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$44.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$40.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$40.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$42.29
|
| Rate for Payer: Fidelis Medicare Advantage |
$44.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$42.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$44.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$44.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$33.39
|
| Rate for Payer: Healthfirst Commercial |
$44.52
|
| Rate for Payer: Healthfirst Essential Plan |
$100.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$42.29
|
| Rate for Payer: Healthfirst QHP |
$44.52
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$31.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$44.52
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$37.84
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$31.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$44.52
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$33.39
|
| Rate for Payer: SOMOS Essential |
$33.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$44.52
|
|
|
PR IN SITU HYBRIDIZATION 1ST PROBE STAIN
|
Professional
|
Both
|
$760.97
|
|
|
Service Code
|
HCPCS 88365
|
| Min. Negotiated Rate |
$139.63 |
| Max. Negotiated Rate |
$448.81 |
| Rate for Payer: Cash Price |
$205.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$199.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$179.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$179.52
|
| Rate for Payer: Fidelis Essential Plan QHP |
$189.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$199.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$189.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$199.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$199.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$149.60
|
| Rate for Payer: Healthfirst Commercial |
$199.47
|
| Rate for Payer: Healthfirst Essential Plan |
$448.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$189.50
|
| Rate for Payer: Healthfirst QHP |
$199.47
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$139.63
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$199.47
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$169.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$139.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$199.47
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$149.60
|
| Rate for Payer: SOMOS Essential |
$149.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$199.47
|
|
|
PR IN-SITU VEIN BYPASS FEMORAL-POPLITEAL
|
Professional
|
Both
|
$6,416.34
|
|
|
Service Code
|
HCPCS 35583
|
| Min. Negotiated Rate |
$1,172.40 |
| Max. Negotiated Rate |
$3,768.43 |
| Rate for Payer: Cash Price |
$1,695.59
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,674.86
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,507.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,507.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,591.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,674.86
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,591.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,674.86
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,674.86
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,256.14
|
| Rate for Payer: Healthfirst Commercial |
$1,674.86
|
| Rate for Payer: Healthfirst Essential Plan |
$3,768.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,591.12
|
| Rate for Payer: Healthfirst QHP |
$1,674.86
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,172.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,674.86
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,423.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,172.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,674.86
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,256.14
|
| Rate for Payer: SOMOS Essential |
$1,256.14
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,674.86
|
|
|
PR IN-SITU VEIN BYP POP-TIBL PRONEAL
|
Professional
|
Both
|
$6,055.91
|
|
|
Service Code
|
HCPCS 35587
|
| Min. Negotiated Rate |
$1,087.36 |
| Max. Negotiated Rate |
$3,495.08 |
| Rate for Payer: Cash Price |
$1,570.56
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,553.37
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,398.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,398.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,475.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,553.37
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,475.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,553.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,553.37
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,165.03
|
| Rate for Payer: Healthfirst Commercial |
$1,553.37
|
| Rate for Payer: Healthfirst Essential Plan |
$3,495.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,475.70
|
| Rate for Payer: Healthfirst QHP |
$1,553.37
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,087.36
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,553.37
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,320.36
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,087.36
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,553.37
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,165.03
|
| Rate for Payer: SOMOS Essential |
$1,165.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,553.37
|
|
|
PR INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB
|
Professional
|
Both
|
$1,643.92
|
|
|
Service Code
|
HCPCS 33216
|
| Min. Negotiated Rate |
$302.53 |
| Max. Negotiated Rate |
$972.43 |
| Rate for Payer: Cash Price |
$436.16
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$432.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$388.97
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$388.97
|
| Rate for Payer: Fidelis Essential Plan QHP |
$410.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$432.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$410.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$432.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$432.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$324.14
|
| Rate for Payer: Healthfirst Commercial |
$432.19
|
| Rate for Payer: Healthfirst Essential Plan |
$972.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$410.58
|
| Rate for Payer: Healthfirst QHP |
$432.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$302.53
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$432.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$367.36
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$302.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$432.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$324.14
|
| Rate for Payer: SOMOS Essential |
$324.14
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$432.19
|
|
|
PR INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB
|
Professional
|
Both
|
$1,627.36
|
|
|
Service Code
|
HCPCS 33217
|
| Min. Negotiated Rate |
$301.15 |
| Max. Negotiated Rate |
$968.00 |
| Rate for Payer: Cash Price |
$433.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$430.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$387.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$387.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$408.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$430.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$408.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$430.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$430.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$322.67
|
| Rate for Payer: Healthfirst Commercial |
$430.22
|
| Rate for Payer: Healthfirst Essential Plan |
$968.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$408.71
|
| Rate for Payer: Healthfirst QHP |
$430.22
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$301.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$430.22
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$365.69
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$301.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$430.22
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$322.67
|
| Rate for Payer: SOMOS Essential |
$322.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$430.22
|
|
|
PR INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD
|
Professional
|
Both
|
$1,195.50
|
|
|
Service Code
|
HCPCS 22853
|
| Min. Negotiated Rate |
$218.88 |
| Max. Negotiated Rate |
$703.55 |
| Rate for Payer: Cash Price |
$314.97
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$312.69
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$281.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$281.42
|
| Rate for Payer: Fidelis Essential Plan QHP |
$297.06
|
| Rate for Payer: Fidelis Medicare Advantage |
$312.69
|
| Rate for Payer: Fidelis Qualified Health Plan |
$297.06
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$312.69
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$312.69
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$234.52
|
| Rate for Payer: Healthfirst Commercial |
$312.69
|
| Rate for Payer: Healthfirst Essential Plan |
$703.55
|
| Rate for Payer: Healthfirst Medicare Advantage |
$297.06
|
| Rate for Payer: Healthfirst QHP |
$312.69
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$218.88
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$312.69
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$265.79
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$218.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$312.69
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$234.52
|
| Rate for Payer: SOMOS Essential |
$234.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$312.69
|
|
|
PR INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD
|
Professional
|
Both
|
$1,539.69
|
|
|
Service Code
|
HCPCS 22859
|
| Min. Negotiated Rate |
$285.77 |
| Max. Negotiated Rate |
$918.56 |
| Rate for Payer: Cash Price |
$407.56
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$408.25
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$367.43
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$367.43
|
| Rate for Payer: Fidelis Essential Plan QHP |
$387.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$408.25
|
| Rate for Payer: Fidelis Qualified Health Plan |
$387.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$408.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$408.25
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$306.19
|
| Rate for Payer: Healthfirst Commercial |
$408.25
|
| Rate for Payer: Healthfirst Essential Plan |
$918.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$387.84
|
| Rate for Payer: Healthfirst QHP |
$408.25
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$285.77
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$408.25
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$347.01
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$285.77
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$408.25
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$306.19
|
| Rate for Payer: SOMOS Essential |
$306.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$408.25
|
|
|
PR INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD
|
Professional
|
Both
|
$1,564.19
|
|
|
Service Code
|
HCPCS 22854
|
| Min. Negotiated Rate |
$286.21 |
| Max. Negotiated Rate |
$919.96 |
| Rate for Payer: Cash Price |
$412.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$408.87
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$367.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$367.98
|
| Rate for Payer: Fidelis Essential Plan QHP |
$388.43
|
| Rate for Payer: Fidelis Medicare Advantage |
$408.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$388.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$408.87
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$408.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$306.65
|
| Rate for Payer: Healthfirst Commercial |
$408.87
|
| Rate for Payer: Healthfirst Essential Plan |
$919.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$388.43
|
| Rate for Payer: Healthfirst QHP |
$408.87
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$286.21
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$408.87
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$347.54
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$286.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$408.87
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$306.65
|
| Rate for Payer: SOMOS Essential |
$306.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$408.87
|
|
|
PR INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL
|
Professional
|
Both
|
$865.62
|
|
|
Service Code
|
HCPCS 36810
|
| Min. Negotiated Rate |
$147.71 |
| Max. Negotiated Rate |
$474.80 |
| Rate for Payer: Cash Price |
$235.26
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$211.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$189.92
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$189.92
|
| Rate for Payer: Fidelis Essential Plan QHP |
$200.47
|
| Rate for Payer: Fidelis Medicare Advantage |
$211.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$200.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$211.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$211.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$158.26
|
| Rate for Payer: Healthfirst Commercial |
$211.02
|
| Rate for Payer: Healthfirst Essential Plan |
$474.80
|
| Rate for Payer: Healthfirst Medicare Advantage |
$200.47
|
| Rate for Payer: Healthfirst QHP |
$211.02
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$147.71
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$211.02
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$179.37
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$147.71
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$211.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$158.26
|
| Rate for Payer: SOMOS Essential |
$158.26
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$211.02
|
|
|
PR INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN
|
Professional
|
Both
|
$503.02
|
|
|
Service Code
|
HCPCS 36800
|
| Min. Negotiated Rate |
$93.81 |
| Max. Negotiated Rate |
$301.52 |
| Rate for Payer: Cash Price |
$135.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$134.01
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$120.61
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$120.61
|
| Rate for Payer: Fidelis Essential Plan QHP |
$127.31
|
| Rate for Payer: Fidelis Medicare Advantage |
$134.01
|
| Rate for Payer: Fidelis Qualified Health Plan |
$127.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$134.01
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$134.01
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$100.51
|
| Rate for Payer: Healthfirst Commercial |
$134.01
|
| Rate for Payer: Healthfirst Essential Plan |
$301.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$127.31
|
| Rate for Payer: Healthfirst QHP |
$134.01
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$93.81
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$134.01
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$113.91
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$93.81
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$134.01
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$100.51
|
| Rate for Payer: SOMOS Essential |
$100.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$134.01
|
|
|
PR INSJ CANNULA HEMO OTH SPX ARVEN XTRNL REVJ/CLSR
|
Professional
|
Both
|
$606.62
|
|
|
Service Code
|
HCPCS 36815
|
| Min. Negotiated Rate |
$110.70 |
| Max. Negotiated Rate |
$355.84 |
| Rate for Payer: Cash Price |
$159.31
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$158.15
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$142.34
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$142.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$150.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$158.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$150.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$158.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$158.15
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$118.61
|
| Rate for Payer: Healthfirst Commercial |
$158.15
|
| Rate for Payer: Healthfirst Essential Plan |
$355.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$150.24
|
| Rate for Payer: Healthfirst QHP |
$158.15
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$110.70
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$158.15
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$134.43
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$110.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$158.15
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$118.61
|
| Rate for Payer: SOMOS Essential |
$118.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$158.15
|
|
|
PR INSJ CNULA ISLTD XC-CIRCJ REG CHEMOTX XTR RMVL
|
Professional
|
Both
|
$6,337.35
|
|
|
Service Code
|
HCPCS 36823
|
| Min. Negotiated Rate |
$1,173.70 |
| Max. Negotiated Rate |
$3,772.62 |
| Rate for Payer: Cash Price |
$1,689.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,676.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,509.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,509.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,592.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,676.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,592.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,676.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,676.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,257.54
|
| Rate for Payer: Healthfirst Commercial |
$1,676.72
|
| Rate for Payer: Healthfirst Essential Plan |
$3,772.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,592.88
|
| Rate for Payer: Healthfirst QHP |
$1,676.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,173.70
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,676.72
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,425.21
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,173.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,676.72
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,257.54
|
| Rate for Payer: SOMOS Essential |
$1,257.54
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,676.72
|
|
|
PR INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN
|
Professional
|
Both
|
$2,265.83
|
|
|
Service Code
|
HCPCS 33224
|
| Min. Negotiated Rate |
$413.54 |
| Max. Negotiated Rate |
$1,329.23 |
| Rate for Payer: Cash Price |
$596.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$590.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$531.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$531.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$561.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$590.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$561.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$590.77
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$590.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$443.08
|
| Rate for Payer: Healthfirst Commercial |
$590.77
|
| Rate for Payer: Healthfirst Essential Plan |
$1,329.23
|
| Rate for Payer: Healthfirst Medicare Advantage |
$561.23
|
| Rate for Payer: Healthfirst QHP |
$590.77
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$413.54
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$590.77
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$502.15
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$413.54
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$590.77
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$443.08
|
| Rate for Payer: SOMOS Essential |
$443.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$590.77
|
|
