|
PR INTRODUCTION CATHETER AORTA
|
Professional
|
Both
|
$607.57
|
|
|
Service Code
|
HCPCS 36200
|
| Min. Negotiated Rate |
$113.08 |
| Max. Negotiated Rate |
$363.46 |
| Rate for Payer: Cash Price |
$161.88
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$161.54
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$145.39
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$145.39
|
| Rate for Payer: Fidelis Essential Plan QHP |
$153.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$161.54
|
| Rate for Payer: Fidelis Qualified Health Plan |
$153.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$161.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$161.54
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$121.16
|
| Rate for Payer: Healthfirst Commercial |
$161.54
|
| Rate for Payer: Healthfirst Essential Plan |
$363.46
|
| Rate for Payer: Healthfirst Medicare Advantage |
$153.46
|
| Rate for Payer: Healthfirst QHP |
$161.54
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$113.08
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$161.54
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$137.31
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$113.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$161.54
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$121.16
|
| Rate for Payer: SOMOS Essential |
$121.16
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$161.54
|
|
|
PR INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE
|
Professional
|
Both
|
$79.91
|
|
|
Service Code
|
HCPCS 44500
|
| Min. Negotiated Rate |
$14.94 |
| Max. Negotiated Rate |
$48.02 |
| Rate for Payer: Cash Price |
$21.21
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$21.34
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$19.21
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$19.21
|
| Rate for Payer: Fidelis Essential Plan QHP |
$20.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$21.34
|
| Rate for Payer: Fidelis Qualified Health Plan |
$20.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.34
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21.34
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.00
|
| Rate for Payer: Healthfirst Commercial |
$21.34
|
| Rate for Payer: Healthfirst Essential Plan |
$48.02
|
| Rate for Payer: Healthfirst Medicare Advantage |
$20.27
|
| Rate for Payer: Healthfirst QHP |
$21.34
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$14.94
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$21.34
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$18.14
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$14.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$21.34
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$16.00
|
| Rate for Payer: SOMOS Essential |
$16.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21.34
|
|
|
PR INTRO NEEDLE/INTRACATH AORTIC TRANSLUMBAR
|
Professional
|
Both
|
$516.32
|
|
|
Service Code
|
HCPCS 36160
|
| Min. Negotiated Rate |
$96.02 |
| Max. Negotiated Rate |
$308.63 |
| Rate for Payer: Cash Price |
$138.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$137.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$123.45
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$123.45
|
| Rate for Payer: Fidelis Essential Plan QHP |
$130.31
|
| Rate for Payer: Fidelis Medicare Advantage |
$137.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$130.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$137.17
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$137.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$102.88
|
| Rate for Payer: Healthfirst Commercial |
$137.17
|
| Rate for Payer: Healthfirst Essential Plan |
$308.63
|
| Rate for Payer: Healthfirst Medicare Advantage |
$130.31
|
| Rate for Payer: Healthfirst QHP |
$137.17
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$96.02
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$137.17
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$116.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$96.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$137.17
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$102.88
|
| Rate for Payer: SOMOS Essential |
$102.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$137.17
|
|
|
PR INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY
|
Professional
|
Both
|
$675.43
|
|
|
Service Code
|
HCPCS 36100
|
| Min. Negotiated Rate |
$123.61 |
| Max. Negotiated Rate |
$397.31 |
| Rate for Payer: Cash Price |
$178.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$176.58
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$158.92
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$158.92
|
| Rate for Payer: Fidelis Essential Plan QHP |
$167.75
|
| Rate for Payer: Fidelis Medicare Advantage |
$176.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$167.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$176.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$176.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$132.44
|
| Rate for Payer: Healthfirst Commercial |
$176.58
|
| Rate for Payer: Healthfirst Essential Plan |
$397.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$167.75
|
| Rate for Payer: Healthfirst QHP |
$176.58
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$123.61
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$176.58
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$150.09
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$123.61
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$176.58
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$132.44
|
| Rate for Payer: SOMOS Essential |
$132.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$176.58
|
|
|
PR INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY
|
Professional
|
Both
|
$386.65
|
|
|
Service Code
|
HCPCS 36140
|
| Min. Negotiated Rate |
$71.06 |
| Max. Negotiated Rate |
$228.40 |
| Rate for Payer: Cash Price |
$102.76
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$101.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$91.36
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$91.36
|
| Rate for Payer: Fidelis Essential Plan QHP |
$96.43
|
| Rate for Payer: Fidelis Medicare Advantage |
$101.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$96.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$101.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$101.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$76.13
|
| Rate for Payer: Healthfirst Commercial |
$101.51
|
| Rate for Payer: Healthfirst Essential Plan |
$228.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$96.43
|
| Rate for Payer: Healthfirst QHP |
$101.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$71.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$101.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$86.28
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$71.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$101.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$76.13
|
| Rate for Payer: SOMOS Essential |
$76.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$101.51
|
|
|
PR INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ
|
Professional
|
Both
|
$4,722.59
|
|
|
Service Code
|
HCPCS 44615
|
| Min. Negotiated Rate |
$887.77 |
| Max. Negotiated Rate |
$2,853.56 |
| Rate for Payer: Cash Price |
$1,268.33
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,268.25
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,141.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,141.42
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,204.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,268.25
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,204.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,268.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,268.25
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$951.19
|
| Rate for Payer: Healthfirst Commercial |
$1,268.25
|
| Rate for Payer: Healthfirst Essential Plan |
$2,853.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,204.84
|
| Rate for Payer: Healthfirst QHP |
$1,268.25
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$887.77
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,268.25
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,078.01
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$887.77
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,268.25
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$951.19
|
| Rate for Payer: SOMOS Essential |
$951.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,268.25
|
|
|
PR INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE
|
Professional
|
Both
|
$599.76
|
|
|
Service Code
|
HCPCS 31500
|
| Min. Negotiated Rate |
$113.33 |
| Max. Negotiated Rate |
$364.27 |
| Rate for Payer: Cash Price |
$160.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$161.90
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$145.71
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$145.71
|
| Rate for Payer: Fidelis Essential Plan QHP |
$153.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$161.90
|
| Rate for Payer: Fidelis Qualified Health Plan |
$153.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$161.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$161.90
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$121.42
|
| Rate for Payer: Healthfirst Commercial |
$161.90
|
| Rate for Payer: Healthfirst Essential Plan |
$364.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$153.81
|
| Rate for Payer: Healthfirst QHP |
$161.90
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$113.33
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$161.90
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$137.62
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$113.33
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$161.90
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$121.42
|
| Rate for Payer: SOMOS Essential |
$121.42
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$161.90
|
|
|
PR IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES
|
Professional
|
Both
|
$130.66
|
|
|
Service Code
|
HCPCS 95940
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$80.01 |
| Rate for Payer: Amida Care Medicaid |
$16.65
|
| Rate for Payer: Cash Price |
$35.61
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$35.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$32.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$32.00
|
| Rate for Payer: Fidelis Essential Plan QHP |
$33.78
|
| Rate for Payer: Fidelis Medicare Advantage |
$35.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$33.78
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$35.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$35.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26.67
|
| Rate for Payer: Healthfirst Commercial |
$35.56
|
| Rate for Payer: Healthfirst Essential Plan |
$80.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$33.78
|
| Rate for Payer: Healthfirst QHP |
$35.56
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$24.89
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$35.56
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$30.23
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$24.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$35.56
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26.67
|
| Rate for Payer: SOMOS Essential |
$26.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$35.56
|
|
|
PR IPECAC/SIMILAR ADMN EMESIS&OBS STOMACH EMPTIED
|
Professional
|
Both
|
$130.69
|
|
|
Service Code
|
HCPCS 99175
|
| Min. Negotiated Rate |
$24.61 |
| Max. Negotiated Rate |
$79.11 |
| Rate for Payer: Cash Price |
$35.60
|
| 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 IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES
|
Professional
|
Both
|
$443.25
|
|
|
Service Code
|
HCPCS 99255
|
| Min. Negotiated Rate |
$80.35 |
| Max. Negotiated Rate |
$80.35 |
| Rate for Payer: Amida Care Medicaid |
$80.35
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES
|
Professional
|
Both
|
$255.75
|
|
|
Service Code
|
HCPCS 99253
|
| Min. Negotiated Rate |
$45.13 |
| Max. Negotiated Rate |
$45.13 |
| Rate for Payer: Amida Care Medicaid |
$45.13
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES
|
Professional
|
Both
|
$364.50
|
|
|
Service Code
|
HCPCS 99254
|
| Min. Negotiated Rate |
$65.11 |
| Max. Negotiated Rate |
$65.11 |
| Rate for Payer: Amida Care Medicaid |
$65.11
|
|
|
PR IP/OBS CONSLTJ NEW/EST PT SF MDM 35 MINUTES
|
Professional
|
Both
|
$162.00
|
|
|
Service Code
|
HCPCS 99252
|
| Min. Negotiated Rate |
$30.24 |
| Max. Negotiated Rate |
$30.24 |
| Rate for Payer: Amida Care Medicaid |
$30.24
|
|
|
PR IRDEC CRNLSCLRL/CRNL SCTJ CYCLECTOMY
|
Professional
|
Both
|
$4,499.88
|
|
|
Service Code
|
HCPCS 66605
|
| Min. Negotiated Rate |
$848.93 |
| Max. Negotiated Rate |
$2,728.71 |
| Rate for Payer: Cash Price |
$1,234.58
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,212.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,091.48
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,091.48
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,152.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,212.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,152.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,212.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,212.76
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$909.57
|
| Rate for Payer: Healthfirst Commercial |
$1,212.76
|
| Rate for Payer: Healthfirst Essential Plan |
$2,728.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,152.12
|
| Rate for Payer: Healthfirst QHP |
$1,212.76
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$848.93
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,212.76
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,030.85
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$848.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,212.76
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$909.57
|
| Rate for Payer: SOMOS Essential |
$909.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,212.76
|
|
|
PR IRDEC CRNLSCLRL/CRNL SCTJ OPTICAL SPX
|
Professional
|
Both
|
$2,354.24
|
|
|
Service Code
|
HCPCS 66635
|
| Min. Negotiated Rate |
$448.71 |
| Max. Negotiated Rate |
$1,442.30 |
| Rate for Payer: Cash Price |
$649.46
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$641.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$576.92
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$576.92
|
| Rate for Payer: Fidelis Essential Plan QHP |
$608.97
|
| Rate for Payer: Fidelis Medicare Advantage |
$641.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$608.97
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$641.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$641.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$480.76
|
| Rate for Payer: Healthfirst Commercial |
$641.02
|
| Rate for Payer: Healthfirst Essential Plan |
$1,442.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$608.97
|
| Rate for Payer: Healthfirst QHP |
$641.02
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$448.71
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$641.02
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$544.87
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$448.71
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$641.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$480.76
|
| Rate for Payer: SOMOS Essential |
$480.76
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$641.02
|
|
|
PR IRDEC CRNLSCLRL/CRNL SCTJ PRPH GLC SPX
|
Professional
|
Both
|
$1,770.76
|
|
|
Service Code
|
HCPCS 66625
|
| Min. Negotiated Rate |
$336.99 |
| Max. Negotiated Rate |
$1,083.19 |
| Rate for Payer: Cash Price |
$487.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$481.42
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$433.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$433.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$457.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$481.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$457.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$481.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$481.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$361.06
|
| Rate for Payer: Healthfirst Commercial |
$481.42
|
| Rate for Payer: Healthfirst Essential Plan |
$1,083.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$457.35
|
| Rate for Payer: Healthfirst QHP |
$481.42
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$336.99
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$481.42
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$409.21
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$336.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$481.42
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$361.06
|
| Rate for Payer: SOMOS Essential |
$361.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$481.42
|
|
|
PR IRDEC CRNLSCLRL/CRNL SCTJ RMVL LES
|
Professional
|
Both
|
$3,773.74
|
|
|
Service Code
|
HCPCS 66600
|
| Min. Negotiated Rate |
$707.14 |
| Max. Negotiated Rate |
$2,272.95 |
| Rate for Payer: Cash Price |
$1,033.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,010.20
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$909.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$909.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$959.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,010.20
|
| Rate for Payer: Fidelis Qualified Health Plan |
$959.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,010.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,010.20
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$757.65
|
| Rate for Payer: Healthfirst Commercial |
$1,010.20
|
| Rate for Payer: Healthfirst Essential Plan |
$2,272.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$959.69
|
| Rate for Payer: Healthfirst QHP |
$1,010.20
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$707.14
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,010.20
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$858.67
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$707.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,010.20
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$757.65
|
| Rate for Payer: SOMOS Essential |
$757.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,010.20
|
|
|
PR IRDEC CRNLSCLRL/CRNL SCTJ SECTOR GLC SPX
|
Professional
|
Both
|
$2,333.03
|
|
|
Service Code
|
HCPCS 66630
|
| Min. Negotiated Rate |
$444.92 |
| Max. Negotiated Rate |
$1,430.10 |
| Rate for Payer: Cash Price |
$643.96
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$635.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$572.04
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$572.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$603.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$635.60
|
| Rate for Payer: Fidelis Qualified Health Plan |
$603.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$635.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$635.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$476.70
|
| Rate for Payer: Healthfirst Commercial |
$635.60
|
| Rate for Payer: Healthfirst Essential Plan |
$1,430.10
|
| Rate for Payer: Healthfirst Medicare Advantage |
$603.82
|
| Rate for Payer: Healthfirst QHP |
$635.60
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$444.92
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$635.60
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$540.26
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$444.92
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$635.60
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$476.70
|
| Rate for Payer: SOMOS Essential |
$476.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$635.60
|
|
|
PR IRIDOPLASTY PHOTOCOAGULATION 1/> SESSIONS
|
Professional
|
Both
|
$1,749.13
|
|
|
Service Code
|
HCPCS 66762
|
| Min. Negotiated Rate |
$334.19 |
| Max. Negotiated Rate |
$1,074.19 |
| Rate for Payer: Cash Price |
$482.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$477.42
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$429.68
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$429.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$453.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$477.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$453.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$477.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$477.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$358.06
|
| Rate for Payer: Healthfirst Commercial |
$477.42
|
| Rate for Payer: Healthfirst Essential Plan |
$1,074.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$453.55
|
| Rate for Payer: Healthfirst QHP |
$477.42
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$334.19
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$477.42
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$405.81
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$334.19
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$477.42
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$358.06
|
| Rate for Payer: SOMOS Essential |
$358.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$477.42
|
|
|
PR IRIDOTOMY/IRRIDECTOMY LASER SURG PER SESSION
|
Professional
|
Both
|
$973.42
|
|
|
Service Code
|
HCPCS 66761
|
| Min. Negotiated Rate |
$184.46 |
| Max. Negotiated Rate |
$592.90 |
| Rate for Payer: Cash Price |
$268.56
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$263.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$237.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$237.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$250.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$263.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$250.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$263.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$263.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$197.63
|
| Rate for Payer: Healthfirst Commercial |
$263.51
|
| Rate for Payer: Healthfirst Essential Plan |
$592.90
|
| Rate for Payer: Healthfirst Medicare Advantage |
$250.33
|
| Rate for Payer: Healthfirst QHP |
$263.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$184.46
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$263.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$223.98
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$184.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$263.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$197.63
|
| Rate for Payer: SOMOS Essential |
$197.63
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$263.51
|
|
|
PR IRIDOTOMY STAB INC SPX TRANSFIXION
|
Professional
|
Both
|
$1,792.11
|
|
|
Service Code
|
HCPCS 66505
|
| Min. Negotiated Rate |
$336.40 |
| Max. Negotiated Rate |
$1,081.28 |
| Rate for Payer: Cash Price |
$492.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$480.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$432.51
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$432.51
|
| Rate for Payer: Fidelis Essential Plan QHP |
$456.54
|
| Rate for Payer: Fidelis Medicare Advantage |
$480.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$456.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$480.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$480.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$360.43
|
| Rate for Payer: Healthfirst Commercial |
$480.57
|
| Rate for Payer: Healthfirst Essential Plan |
$1,081.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$456.54
|
| Rate for Payer: Healthfirst QHP |
$480.57
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$336.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$480.57
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$408.48
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$336.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$480.57
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$360.43
|
| Rate for Payer: SOMOS Essential |
$360.43
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$480.57
|
|
|
PR IRIDOTOMY STAB INC SPX XCP TRANSFIXION
|
Professional
|
Both
|
$1,652.98
|
|
|
Service Code
|
HCPCS 66500
|
| Min. Negotiated Rate |
$308.96 |
| Max. Negotiated Rate |
$993.08 |
| Rate for Payer: Cash Price |
$453.32
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$441.37
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$397.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$397.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$419.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$441.37
|
| Rate for Payer: Fidelis Qualified Health Plan |
$419.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$441.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$441.37
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$331.03
|
| Rate for Payer: Healthfirst Commercial |
$441.37
|
| Rate for Payer: Healthfirst Essential Plan |
$993.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$419.30
|
| Rate for Payer: Healthfirst QHP |
$441.37
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$308.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$441.37
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$375.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$308.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$441.37
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$331.03
|
| Rate for Payer: SOMOS Essential |
$331.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$441.37
|
|
|
PR IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST
|
Professional
|
Both
|
$109.80
|
|
|
Service Code
|
HCPCS 96523
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Cash Price |
$29.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$28.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$25.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$25.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$26.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$28.00
|
| Rate for Payer: Fidelis Qualified Health Plan |
$26.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$28.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$28.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$21.00
|
| Rate for Payer: Healthfirst Commercial |
$28.00
|
| Rate for Payer: Healthfirst Essential Plan |
$63.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$26.60
|
| Rate for Payer: Healthfirst QHP |
$28.00
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$19.60
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$28.00
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$23.80
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$19.60
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$28.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$21.00
|
| Rate for Payer: SOMOS Essential |
$21.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$28.00
|
|
|
PR IRRIGATION CORPORA CAVERNOSA PRIAPISM
|
Professional
|
Both
|
$569.66
|
|
|
Service Code
|
HCPCS 54220
|
| Min. Negotiated Rate |
$108.38 |
| Max. Negotiated Rate |
$348.37 |
| Rate for Payer: Cash Price |
$156.57
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$154.83
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$139.35
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$139.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$147.09
|
| Rate for Payer: Fidelis Medicare Advantage |
$154.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$147.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$154.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$154.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$116.12
|
| Rate for Payer: Healthfirst Commercial |
$154.83
|
| Rate for Payer: Healthfirst Essential Plan |
$348.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$147.09
|
| Rate for Payer: Healthfirst QHP |
$154.83
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$108.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$154.83
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$131.61
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$108.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$154.83
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$116.12
|
| Rate for Payer: SOMOS Essential |
$116.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$154.83
|
|
|
PR IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE
|
Professional
|
Both
|
$111.83
|
|
|
Service Code
|
HCPCS 57150
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$65.09 |
| Rate for Payer: Cash Price |
$29.91
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$28.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$26.04
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$26.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$27.48
|
| Rate for Payer: Fidelis Medicare Advantage |
$28.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$27.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$28.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$28.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$21.70
|
| Rate for Payer: Healthfirst Commercial |
$28.93
|
| Rate for Payer: Healthfirst Essential Plan |
$65.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$27.48
|
| Rate for Payer: Healthfirst QHP |
$28.93
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$20.25
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$28.93
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$24.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$20.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$28.93
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$21.70
|
| Rate for Payer: SOMOS Essential |
$21.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$28.93
|
|
