|
PR INTERMEDIATE VISUAL FIELD XM UNI/BI I&R
|
Professional
|
Both
|
$81.59
|
|
|
Service Code
|
HCPCS 92082 26
|
| Min. Negotiated Rate |
$15.51 |
| Max. Negotiated Rate |
$51.44 |
| Rate for Payer: Amida Care Medicaid |
$51.44
|
| Rate for Payer: Cash Price |
$22.43
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$22.16
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$19.94
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$19.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$21.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$22.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$22.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.62
|
| Rate for Payer: Healthfirst Commercial |
$22.16
|
| Rate for Payer: Healthfirst Essential Plan |
$49.86
|
| Rate for Payer: Healthfirst Medicare Advantage |
$21.05
|
| Rate for Payer: Healthfirst QHP |
$22.16
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$15.51
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$22.16
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$18.84
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$15.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$22.16
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$16.62
|
| Rate for Payer: SOMOS Essential |
$16.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$22.16
|
|
|
PR INTERMEDIATE VISUAL FIELD XM UNI/BI I&R
|
Professional
|
Both
|
$113.44
|
|
|
Service Code
|
HCPCS 92082 TC
|
| Min. Negotiated Rate |
$21.62 |
| Max. Negotiated Rate |
$69.50 |
| Rate for Payer: Amida Care Medicaid |
$51.44
|
| Rate for Payer: Cash Price |
$31.67
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$30.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$27.80
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$27.80
|
| Rate for Payer: Fidelis Essential Plan QHP |
$29.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$30.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$29.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23.17
|
| Rate for Payer: Healthfirst Commercial |
$30.89
|
| Rate for Payer: Healthfirst Essential Plan |
$69.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$29.35
|
| Rate for Payer: Healthfirst QHP |
$30.89
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$21.62
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$30.89
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$26.26
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$21.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$30.89
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23.17
|
| Rate for Payer: SOMOS Essential |
$23.17
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$30.89
|
|
|
PR INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE
|
Professional
|
Both
|
$761.95
|
|
|
Service Code
|
HCPCS 64727
|
| Min. Negotiated Rate |
$140.01 |
| Max. Negotiated Rate |
$450.05 |
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$200.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$180.02
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$180.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$190.02
|
| Rate for Payer: Fidelis Medicare Advantage |
$200.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$190.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$200.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$200.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$150.01
|
| Rate for Payer: Healthfirst Commercial |
$200.02
|
| Rate for Payer: Healthfirst Essential Plan |
$450.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$190.02
|
| Rate for Payer: Healthfirst QHP |
$200.02
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$140.01
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$200.02
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$170.02
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$140.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$200.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$150.01
|
| Rate for Payer: SOMOS Essential |
$150.01
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$200.02
|
|
|
PR INTERPELVIABDOMINAL AMPUTATION
|
Professional
|
Both
|
$7,163.49
|
|
|
Service Code
|
HCPCS 27290
|
| Min. Negotiated Rate |
$1,342.48 |
| Max. Negotiated Rate |
$4,315.12 |
| Rate for Payer: Cash Price |
$1,927.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,917.83
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,726.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,726.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,821.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,917.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,821.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,917.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,917.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,438.37
|
| Rate for Payer: Healthfirst Commercial |
$1,917.83
|
| Rate for Payer: Healthfirst Essential Plan |
$4,315.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,821.94
|
| Rate for Payer: Healthfirst QHP |
$1,917.83
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,342.48
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,917.83
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,630.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,342.48
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,917.83
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,438.37
|
| Rate for Payer: SOMOS Essential |
$1,438.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,917.83
|
|
|
PR INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB
|
Professional
|
Both
|
$141.30
|
|
|
Service Code
|
HCPCS 93261 26
|
| Min. Negotiated Rate |
$26.59 |
| Max. Negotiated Rate |
$85.48 |
| Rate for Payer: Amida Care Medicaid |
$39.59
|
| Rate for Payer: Cash Price |
$38.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$37.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$34.19
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$34.19
|
| Rate for Payer: Fidelis Essential Plan QHP |
$36.09
|
| Rate for Payer: Fidelis Medicare Advantage |
$37.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$36.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$37.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$37.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$28.49
|
| Rate for Payer: Healthfirst Commercial |
$37.99
|
| Rate for Payer: Healthfirst Essential Plan |
$85.48
|
| Rate for Payer: Healthfirst Medicare Advantage |
$36.09
|
| Rate for Payer: Healthfirst QHP |
$37.99
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$26.59
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$37.99
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$32.29
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$26.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$37.99
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$28.49
|
| Rate for Payer: SOMOS Essential |
$28.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$37.99
|
|
|
PR INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB
|
Professional
|
Both
|
$150.82
|
|
|
Service Code
|
HCPCS 93261 TC
|
| Min. Negotiated Rate |
$28.15 |
| Max. Negotiated Rate |
$90.47 |
| Rate for Payer: Amida Care Medicaid |
$39.59
|
| Rate for Payer: Cash Price |
$41.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$40.21
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36.19
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$36.19
|
| Rate for Payer: Fidelis Essential Plan QHP |
$38.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$40.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$38.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$40.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30.16
|
| Rate for Payer: Healthfirst Commercial |
$40.21
|
| Rate for Payer: Healthfirst Essential Plan |
$90.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$38.20
|
| Rate for Payer: Healthfirst QHP |
$40.21
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$28.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$40.21
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$34.18
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$28.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$40.21
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$30.16
|
| Rate for Payer: SOMOS Essential |
$30.16
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$40.21
|
|
|
PR INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB
|
Professional
|
Both
|
$292.08
|
|
|
Service Code
|
HCPCS 93261
|
| Min. Negotiated Rate |
$39.59 |
| Max. Negotiated Rate |
$175.95 |
| Rate for Payer: Amida Care Medicaid |
$39.59
|
| Rate for Payer: Cash Price |
$79.16
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$78.20
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$70.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$70.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$74.29
|
| Rate for Payer: Fidelis Medicare Advantage |
$78.20
|
| Rate for Payer: Fidelis Qualified Health Plan |
$74.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$78.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$78.20
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$58.65
|
| Rate for Payer: Healthfirst Commercial |
$78.20
|
| Rate for Payer: Healthfirst Essential Plan |
$175.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$74.29
|
| Rate for Payer: Healthfirst QHP |
$78.20
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$54.74
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$78.20
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$66.47
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$54.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$78.20
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$58.65
|
| Rate for Payer: SOMOS Essential |
$58.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$78.20
|
|
|
PR INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR
|
Professional
|
Both
|
$82.32
|
|
|
Service Code
|
HCPCS 93292 26
|
| Min. Negotiated Rate |
$15.58 |
| Max. Negotiated Rate |
$50.09 |
| Rate for Payer: Amida Care Medicaid |
$29.51
|
| Rate for Payer: Cash Price |
$22.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$22.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$20.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$21.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$22.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$22.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.70
|
| Rate for Payer: Healthfirst Commercial |
$22.26
|
| Rate for Payer: Healthfirst Essential Plan |
$50.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$21.15
|
| Rate for Payer: Healthfirst QHP |
$22.26
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$15.58
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$22.26
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$18.92
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$15.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$22.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$16.70
|
| Rate for Payer: SOMOS Essential |
$16.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$22.26
|
|
|
PR INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR
|
Professional
|
Both
|
$133.56
|
|
|
Service Code
|
HCPCS 93292 TC
|
| Min. Negotiated Rate |
$24.61 |
| Max. Negotiated Rate |
$79.11 |
| Rate for Payer: Amida Care Medicaid |
$29.51
|
| Rate for Payer: Cash Price |
$36.38
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$35.16
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$31.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$31.64
|
| Rate for Payer: Fidelis Essential Plan QHP |
$33.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$35.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$33.40
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$35.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$35.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26.37
|
| Rate for Payer: Healthfirst Commercial |
$35.16
|
| Rate for Payer: Healthfirst Essential Plan |
$79.11
|
| Rate for Payer: Healthfirst Medicare Advantage |
$33.40
|
| Rate for Payer: Healthfirst QHP |
$35.16
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$24.61
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$35.16
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$29.89
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$24.61
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$35.16
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26.37
|
| Rate for Payer: SOMOS Essential |
$26.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$35.16
|
|
|
PR INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR
|
Professional
|
Both
|
$215.88
|
|
|
Service Code
|
HCPCS 93292
|
| Min. Negotiated Rate |
$29.51 |
| Max. Negotiated Rate |
$129.19 |
| Rate for Payer: Amida Care Medicaid |
$29.51
|
| Rate for Payer: Cash Price |
$58.92
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$57.42
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$51.68
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$51.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$54.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$57.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$54.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$57.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$57.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$43.06
|
| Rate for Payer: Healthfirst Commercial |
$57.42
|
| Rate for Payer: Healthfirst Essential Plan |
$129.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$54.55
|
| Rate for Payer: Healthfirst QHP |
$57.42
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$40.19
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$57.42
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$48.81
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$40.19
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$57.42
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$43.06
|
| Rate for Payer: SOMOS Essential |
$43.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$57.42
|
|
|
PR INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB
|
Professional
|
Both
|
$146.76
|
|
|
Service Code
|
HCPCS 93295
|
| Min. Negotiated Rate |
$27.45 |
| Max. Negotiated Rate |
$88.25 |
| Rate for Payer: Amida Care Medicaid |
$34.57
|
| Rate for Payer: Cash Price |
$40.33
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$39.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$35.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$35.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$37.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$39.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$37.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$39.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$39.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29.41
|
| Rate for Payer: Healthfirst Commercial |
$39.22
|
| Rate for Payer: Healthfirst Essential Plan |
$88.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$37.26
|
| Rate for Payer: Healthfirst QHP |
$39.22
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$27.45
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$39.22
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$33.34
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$27.45
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$39.22
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$29.41
|
| Rate for Payer: SOMOS Essential |
$29.41
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$39.22
|
|
|
PR INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS
|
Professional
|
Both
|
$171.33
|
|
|
Service Code
|
HCPCS 93750
|
| Min. Negotiated Rate |
$23.49 |
| Max. Negotiated Rate |
$104.15 |
| Rate for Payer: Amida Care Medicaid |
$23.49
|
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$46.29
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$41.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$41.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$43.98
|
| Rate for Payer: Fidelis Medicare Advantage |
$46.29
|
| Rate for Payer: Fidelis Qualified Health Plan |
$43.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$46.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$46.29
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$34.72
|
| Rate for Payer: Healthfirst Commercial |
$46.29
|
| Rate for Payer: Healthfirst Essential Plan |
$104.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$43.98
|
| Rate for Payer: Healthfirst QHP |
$46.29
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$32.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$46.29
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$39.35
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$32.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$46.29
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$34.72
|
| Rate for Payer: SOMOS Essential |
$34.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$46.29
|
|
|
PR INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$143.61
|
|
|
Service Code
|
HCPCS 93290 TC
|
| Min. Negotiated Rate |
$25.03 |
| Max. Negotiated Rate |
$83.47 |
| Rate for Payer: Amida Care Medicaid |
$25.03
|
| Rate for Payer: Cash Price |
$38.74
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$37.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$33.39
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$33.39
|
| Rate for Payer: Fidelis Essential Plan QHP |
$35.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$37.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$35.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$37.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$37.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$27.82
|
| Rate for Payer: Healthfirst Commercial |
$37.10
|
| Rate for Payer: Healthfirst Essential Plan |
$83.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$35.24
|
| Rate for Payer: Healthfirst QHP |
$37.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$25.97
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$37.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$31.54
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$25.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$37.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$27.82
|
| Rate for Payer: SOMOS Essential |
$27.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$37.10
|
|
|
PR INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$227.36
|
|
|
Service Code
|
HCPCS 93290
|
| Min. Negotiated Rate |
$25.03 |
| Max. Negotiated Rate |
$133.56 |
| Rate for Payer: Amida Care Medicaid |
$25.03
|
| Rate for Payer: Cash Price |
$61.27
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$59.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$53.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$53.42
|
| Rate for Payer: Fidelis Essential Plan QHP |
$56.39
|
| Rate for Payer: Fidelis Medicare Advantage |
$59.36
|
| Rate for Payer: Fidelis Qualified Health Plan |
$56.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$59.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$59.36
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$44.52
|
| Rate for Payer: Healthfirst Commercial |
$59.36
|
| Rate for Payer: Healthfirst Essential Plan |
$133.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$56.39
|
| Rate for Payer: Healthfirst QHP |
$59.36
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$41.55
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$59.36
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$50.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$41.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$59.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$44.52
|
| Rate for Payer: SOMOS Essential |
$44.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$59.36
|
|
|
PR INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$83.76
|
|
|
Service Code
|
HCPCS 93290 26
|
| Min. Negotiated Rate |
$15.58 |
| Max. Negotiated Rate |
$50.09 |
| Rate for Payer: Amida Care Medicaid |
$25.03
|
| Rate for Payer: Cash Price |
$22.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$22.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$20.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$21.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$22.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$22.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.70
|
| Rate for Payer: Healthfirst Commercial |
$22.26
|
| Rate for Payer: Healthfirst Essential Plan |
$50.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$21.15
|
| Rate for Payer: Healthfirst QHP |
$22.26
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$15.58
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$22.26
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$18.92
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$15.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$22.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$16.70
|
| Rate for Payer: SOMOS Essential |
$16.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$22.26
|
|
|
PR INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$79.59
|
|
|
Service Code
|
HCPCS 93288 26
|
| Min. Negotiated Rate |
$15.15 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Amida Care Medicaid |
$34.23
|
| Rate for Payer: Cash Price |
$21.91
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$21.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$19.48
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$19.48
|
| Rate for Payer: Fidelis Essential Plan QHP |
$20.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$21.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$20.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.23
|
| Rate for Payer: Healthfirst Commercial |
$21.64
|
| Rate for Payer: Healthfirst Essential Plan |
$48.69
|
| Rate for Payer: Healthfirst Medicare Advantage |
$20.56
|
| Rate for Payer: Healthfirst QHP |
$21.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$15.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$21.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$18.39
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$15.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$21.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$16.23
|
| Rate for Payer: SOMOS Essential |
$16.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21.64
|
|
|
PR INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$157.99
|
|
|
Service Code
|
HCPCS 93288 TC
|
| Min. Negotiated Rate |
$28.96 |
| Max. Negotiated Rate |
$93.08 |
| Rate for Payer: Amida Care Medicaid |
$34.23
|
| Rate for Payer: Cash Price |
$42.67
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$41.37
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$37.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$37.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$39.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$41.37
|
| Rate for Payer: Fidelis Qualified Health Plan |
$39.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$41.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$41.37
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$31.03
|
| Rate for Payer: Healthfirst Commercial |
$41.37
|
| Rate for Payer: Healthfirst Essential Plan |
$93.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$39.30
|
| Rate for Payer: Healthfirst QHP |
$41.37
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$28.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$41.37
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$35.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$28.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$41.37
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$31.03
|
| Rate for Payer: SOMOS Essential |
$31.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$41.37
|
|
|
PR INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON
|
Professional
|
Both
|
$237.58
|
|
|
Service Code
|
HCPCS 93288
|
| Min. Negotiated Rate |
$34.23 |
| Max. Negotiated Rate |
$141.79 |
| Rate for Payer: Amida Care Medicaid |
$34.23
|
| Rate for Payer: Cash Price |
$64.58
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$63.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$56.72
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$56.72
|
| Rate for Payer: Fidelis Essential Plan QHP |
$59.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$63.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$59.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$63.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$63.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$47.27
|
| Rate for Payer: Healthfirst Commercial |
$63.02
|
| Rate for Payer: Healthfirst Essential Plan |
$141.79
|
| Rate for Payer: Healthfirst Medicare Advantage |
$59.87
|
| Rate for Payer: Healthfirst QHP |
$63.02
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$44.11
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$63.02
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$53.57
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$44.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$63.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$47.27
|
| Rate for Payer: SOMOS Essential |
$47.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$63.02
|
|
|
PR INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$209.93
|
|
|
Service Code
|
HCPCS 93291
|
| Min. Negotiated Rate |
$32.74 |
| Max. Negotiated Rate |
$123.17 |
| Rate for Payer: Amida Care Medicaid |
$32.74
|
| Rate for Payer: Cash Price |
$56.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$54.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$49.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$49.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$52.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$54.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$52.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$54.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$54.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$41.05
|
| Rate for Payer: Healthfirst Commercial |
$54.74
|
| Rate for Payer: Healthfirst Essential Plan |
$123.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$52.00
|
| Rate for Payer: Healthfirst QHP |
$54.74
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$38.32
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$54.74
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$46.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$38.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$54.74
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$41.05
|
| Rate for Payer: SOMOS Essential |
$41.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$54.74
|
|
|
PR INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$70.63
|
|
|
Service Code
|
HCPCS 93291 26
|
| Min. Negotiated Rate |
$13.16 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Amida Care Medicaid |
$32.74
|
| Rate for Payer: Cash Price |
$19.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$18.80
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$16.92
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$16.92
|
| Rate for Payer: Fidelis Essential Plan QHP |
$17.86
|
| Rate for Payer: Fidelis Medicare Advantage |
$18.80
|
| Rate for Payer: Fidelis Qualified Health Plan |
$17.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18.80
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$14.10
|
| Rate for Payer: Healthfirst Commercial |
$18.80
|
| Rate for Payer: Healthfirst Essential Plan |
$42.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17.86
|
| Rate for Payer: Healthfirst QHP |
$18.80
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$13.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$18.80
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$15.98
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$13.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$18.80
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$14.10
|
| Rate for Payer: SOMOS Essential |
$14.10
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$18.80
|
|
|
PR INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON
|
Professional
|
Both
|
$139.30
|
|
|
Service Code
|
HCPCS 93291 TC
|
| Min. Negotiated Rate |
$25.16 |
| Max. Negotiated Rate |
$80.86 |
| Rate for Payer: Amida Care Medicaid |
$32.74
|
| Rate for Payer: Cash Price |
$37.17
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$35.94
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$32.35
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$32.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$34.14
|
| Rate for Payer: Fidelis Medicare Advantage |
$35.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$34.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$35.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$35.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26.95
|
| Rate for Payer: Healthfirst Commercial |
$35.94
|
| Rate for Payer: Healthfirst Essential Plan |
$80.86
|
| Rate for Payer: Healthfirst Medicare Advantage |
$34.14
|
| Rate for Payer: Healthfirst QHP |
$35.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$25.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$35.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$30.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$25.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$35.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26.95
|
| Rate for Payer: SOMOS Essential |
$26.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$35.94
|
|
|
PR INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB
|
Professional
|
Both
|
$159.43
|
|
|
Service Code
|
HCPCS 93289 TC
|
| Min. Negotiated Rate |
$28.96 |
| Max. Negotiated Rate |
$93.08 |
| Rate for Payer: Amida Care Medicaid |
$52.45
|
| Rate for Payer: Cash Price |
$43.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$41.37
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$37.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$37.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$39.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$41.37
|
| Rate for Payer: Fidelis Qualified Health Plan |
$39.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$41.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$41.37
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$31.03
|
| Rate for Payer: Healthfirst Commercial |
$41.37
|
| Rate for Payer: Healthfirst Essential Plan |
$93.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$39.30
|
| Rate for Payer: Healthfirst QHP |
$41.37
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$28.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$41.37
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$35.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$28.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$41.37
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$31.03
|
| Rate for Payer: SOMOS Essential |
$31.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$41.37
|
|
|
PR INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB
|
Professional
|
Both
|
$146.58
|
|
|
Service Code
|
HCPCS 93289 26
|
| Min. Negotiated Rate |
$26.99 |
| Max. Negotiated Rate |
$86.76 |
| Rate for Payer: Amida Care Medicaid |
$52.45
|
| Rate for Payer: Cash Price |
$39.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$38.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$34.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$34.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$36.63
|
| Rate for Payer: Fidelis Medicare Advantage |
$38.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$36.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$38.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$38.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$28.92
|
| Rate for Payer: Healthfirst Commercial |
$38.56
|
| Rate for Payer: Healthfirst Essential Plan |
$86.76
|
| Rate for Payer: Healthfirst Medicare Advantage |
$36.63
|
| Rate for Payer: Healthfirst QHP |
$38.56
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$26.99
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$38.56
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$32.78
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$26.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$38.56
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$28.92
|
| Rate for Payer: SOMOS Essential |
$28.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$38.56
|
|
|
PR INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB
|
Professional
|
Both
|
$306.01
|
|
|
Service Code
|
HCPCS 93289
|
| Min. Negotiated Rate |
$52.45 |
| Max. Negotiated Rate |
$179.84 |
| Rate for Payer: Amida Care Medicaid |
$52.45
|
| Rate for Payer: Cash Price |
$82.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$79.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$71.94
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$71.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$75.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$79.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$75.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$79.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$79.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$59.95
|
| Rate for Payer: Healthfirst Commercial |
$79.93
|
| Rate for Payer: Healthfirst Essential Plan |
$179.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$75.93
|
| Rate for Payer: Healthfirst QHP |
$79.93
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$55.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$79.93
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$67.94
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$55.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$79.93
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$59.95
|
| Rate for Payer: SOMOS Essential |
$59.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$79.93
|
|
|
PR INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT
|
Professional
|
Both
|
$758.66
|
|
|
Service Code
|
HCPCS 49411
|
| Min. Negotiated Rate |
$144.82 |
| Max. Negotiated Rate |
$465.48 |
| Rate for Payer: Cash Price |
$205.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$206.88
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$186.19
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$186.19
|
| Rate for Payer: Fidelis Essential Plan QHP |
$196.54
|
| Rate for Payer: Fidelis Medicare Advantage |
$206.88
|
| Rate for Payer: Fidelis Qualified Health Plan |
$196.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$206.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$206.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$155.16
|
| Rate for Payer: Healthfirst Commercial |
$206.88
|
| Rate for Payer: Healthfirst Essential Plan |
$465.48
|
| Rate for Payer: Healthfirst Medicare Advantage |
$196.54
|
| Rate for Payer: Healthfirst QHP |
$206.88
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$144.82
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$206.88
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$175.85
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$144.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$206.88
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$155.16
|
| Rate for Payer: SOMOS Essential |
$155.16
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$206.88
|
|
