|
PR LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Professional
|
Both
|
$1,057.25
|
|
|
Service Code
|
HCPCS 31571
|
| Min. Negotiated Rate |
$199.54 |
| Max. Negotiated Rate |
$641.38 |
| Rate for Payer: Cash Price |
$286.76
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$285.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$256.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$256.55
|
| Rate for Payer: Fidelis Essential Plan QHP |
$270.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$285.06
|
| Rate for Payer: Fidelis Qualified Health Plan |
$270.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$285.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$285.06
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$213.79
|
| Rate for Payer: Healthfirst Commercial |
$285.06
|
| Rate for Payer: Healthfirst Essential Plan |
$641.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$270.81
|
| Rate for Payer: Healthfirst QHP |
$285.06
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$199.54
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$285.06
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$242.30
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$199.54
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$285.06
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$213.79
|
| Rate for Payer: SOMOS Essential |
$213.79
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$285.06
|
|
|
PR LARYNGEAL FUNCTION STUDIES
|
Professional
|
Both
|
$160.93
|
|
|
Service Code
|
HCPCS 92520
|
| Min. Negotiated Rate |
$30.79 |
| Max. Negotiated Rate |
$98.98 |
| Rate for Payer: Cash Price |
$43.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$43.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$39.59
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$39.59
|
| Rate for Payer: Fidelis Essential Plan QHP |
$41.79
|
| Rate for Payer: Fidelis Medicare Advantage |
$43.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$41.79
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$43.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$43.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$32.99
|
| Rate for Payer: Healthfirst Commercial |
$43.99
|
| Rate for Payer: Healthfirst Essential Plan |
$98.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$41.79
|
| Rate for Payer: Healthfirst QHP |
$43.99
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$30.79
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$43.99
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$37.39
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$30.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$43.99
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$32.99
|
| Rate for Payer: SOMOS Essential |
$32.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$43.99
|
|
|
PR LARYNGEAL REINNERVATION NEUROMUSCULAR PEDICLE
|
Professional
|
Both
|
$4,017.86
|
|
|
Service Code
|
HCPCS 31590
|
| Min. Negotiated Rate |
$756.13 |
| Max. Negotiated Rate |
$2,430.41 |
| Rate for Payer: Cash Price |
$1,088.97
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,080.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$972.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$972.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,026.17
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,080.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,026.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,080.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,080.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$810.13
|
| Rate for Payer: Healthfirst Commercial |
$1,080.18
|
| Rate for Payer: Healthfirst Essential Plan |
$2,430.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,026.17
|
| Rate for Payer: Healthfirst QHP |
$1,080.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$756.13
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,080.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$918.15
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$756.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,080.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$810.13
|
| Rate for Payer: SOMOS Essential |
$810.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,080.18
|
|
|
PR LARYNGECTOMY STOT SUPRAGLOTTIC W/O RAD NECK DSJ
|
Professional
|
Both
|
$9,384.73
|
|
|
Service Code
|
HCPCS 31367
|
| Min. Negotiated Rate |
$1,748.67 |
| Max. Negotiated Rate |
$5,620.73 |
| Rate for Payer: Cash Price |
$2,529.19
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,498.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,248.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,248.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,373.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,498.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,373.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,498.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,498.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,873.58
|
| Rate for Payer: Healthfirst Commercial |
$2,498.10
|
| Rate for Payer: Healthfirst Essential Plan |
$5,620.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,373.20
|
| Rate for Payer: Healthfirst QHP |
$2,498.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,748.67
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,498.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,123.39
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,748.67
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,498.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,873.58
|
| Rate for Payer: SOMOS Essential |
$1,873.58
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,498.10
|
|
|
PR LARYNGECTOMY STOT SUPRAGLOTTIC W/RAD NCK DSJ
|
Professional
|
Both
|
$10,375.72
|
|
|
Service Code
|
HCPCS 31368
|
| Min. Negotiated Rate |
$1,931.45 |
| Max. Negotiated Rate |
$6,208.22 |
| Rate for Payer: Cash Price |
$2,795.08
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,759.21
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,483.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,483.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,621.25
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,759.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,621.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,759.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,759.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,069.41
|
| Rate for Payer: Healthfirst Commercial |
$2,759.21
|
| Rate for Payer: Healthfirst Essential Plan |
$6,208.22
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,621.25
|
| Rate for Payer: Healthfirst QHP |
$2,759.21
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,931.45
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,759.21
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,345.33
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,931.45
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,759.21
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,069.41
|
| Rate for Payer: SOMOS Essential |
$2,069.41
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,759.21
|
|
|
PR LARYNGECTOMY TOTAL W/O RADICAL NECK DISSECTION
|
Professional
|
Both
|
$8,871.24
|
|
|
Service Code
|
HCPCS 31360
|
| Min. Negotiated Rate |
$1,654.02 |
| Max. Negotiated Rate |
$5,316.50 |
| Rate for Payer: Cash Price |
$2,393.73
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,362.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,126.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,126.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,244.75
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,362.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,244.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,362.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,362.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,772.17
|
| Rate for Payer: Healthfirst Commercial |
$2,362.89
|
| Rate for Payer: Healthfirst Essential Plan |
$5,316.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,244.75
|
| Rate for Payer: Healthfirst QHP |
$2,362.89
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,654.02
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,362.89
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,008.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,654.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,362.89
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,772.17
|
| Rate for Payer: SOMOS Essential |
$1,772.17
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,362.89
|
|
|
PR LARYNGECTOMY TOTAL W/RADICAL NECK DISSECTION
|
Professional
|
Both
|
$10,939.92
|
|
|
Service Code
|
HCPCS 31365
|
| Min. Negotiated Rate |
$2,040.00 |
| Max. Negotiated Rate |
$6,557.13 |
| Rate for Payer: Cash Price |
$2,946.95
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,914.28
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,622.85
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,622.85
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,768.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,914.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,768.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,914.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,914.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,185.71
|
| Rate for Payer: Healthfirst Commercial |
$2,914.28
|
| Rate for Payer: Healthfirst Essential Plan |
$6,557.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,768.57
|
| Rate for Payer: Healthfirst QHP |
$2,914.28
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,040.00
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,914.28
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,477.14
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,040.00
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,914.28
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,185.71
|
| Rate for Payer: SOMOS Essential |
$2,185.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,914.28
|
|
|
PR LARYNGOPLASTY CRICOID SPLIT W/O GRAFT PLACEMENT
|
Professional
|
Both
|
$5,224.73
|
|
|
Service Code
|
HCPCS 31587
|
| Min. Negotiated Rate |
$980.11 |
| Max. Negotiated Rate |
$3,150.34 |
| Rate for Payer: Cash Price |
$1,413.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,400.15
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,260.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,260.13
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,330.14
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,400.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,330.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,400.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,400.15
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,050.11
|
| Rate for Payer: Healthfirst Commercial |
$1,400.15
|
| Rate for Payer: Healthfirst Essential Plan |
$3,150.34
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,330.14
|
| Rate for Payer: Healthfirst QHP |
$1,400.15
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$980.11
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,400.15
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,190.13
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$980.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,400.15
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,050.11
|
| Rate for Payer: SOMOS Essential |
$1,050.11
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,400.15
|
|
|
PR LARYNGOPLASTY LARYNGEAL STEN W/O STENT < 12 YRS
|
Professional
|
Both
|
$6,666.84
|
|
|
Service Code
|
HCPCS 31551
|
| Min. Negotiated Rate |
$1,248.62 |
| Max. Negotiated Rate |
$4,013.41 |
| Rate for Payer: Cash Price |
$1,802.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,783.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,605.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,605.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,694.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,783.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,694.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,783.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,783.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,337.81
|
| Rate for Payer: Healthfirst Commercial |
$1,783.74
|
| Rate for Payer: Healthfirst Essential Plan |
$4,013.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,694.55
|
| Rate for Payer: Healthfirst QHP |
$1,783.74
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,248.62
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,783.74
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,516.18
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,248.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,783.74
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,337.81
|
| Rate for Payer: SOMOS Essential |
$1,337.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,783.74
|
|
|
PR LARYNGOPLASTY LARYNGEAL STEN W/O STENT 12 YRS >
|
Professional
|
Both
|
$6,440.04
|
|
|
Service Code
|
HCPCS 31552
|
| Min. Negotiated Rate |
$1,205.95 |
| Max. Negotiated Rate |
$3,876.26 |
| Rate for Payer: Cash Price |
$1,739.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,722.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,550.50
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,550.50
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,636.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,722.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,636.64
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,722.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,722.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,292.09
|
| Rate for Payer: Healthfirst Commercial |
$1,722.78
|
| Rate for Payer: Healthfirst Essential Plan |
$3,876.26
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,636.64
|
| Rate for Payer: Healthfirst QHP |
$1,722.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,205.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,722.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,464.36
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,205.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,722.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,292.09
|
| Rate for Payer: SOMOS Essential |
$1,292.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,722.78
|
|
|
PR LARYNGOPLASTY LARYNGEAL STEN W/STENT < 12 YRS
|
Professional
|
Both
|
$7,276.19
|
|
|
Service Code
|
HCPCS 31553
|
| Min. Negotiated Rate |
$1,354.40 |
| Max. Negotiated Rate |
$4,353.44 |
| Rate for Payer: Cash Price |
$1,963.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,934.86
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,741.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,741.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,838.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,934.86
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,838.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,934.86
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,934.86
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,451.14
|
| Rate for Payer: Healthfirst Commercial |
$1,934.86
|
| Rate for Payer: Healthfirst Essential Plan |
$4,353.44
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,838.12
|
| Rate for Payer: Healthfirst QHP |
$1,934.86
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,354.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,934.86
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,644.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,354.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,934.86
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,451.14
|
| Rate for Payer: SOMOS Essential |
$1,451.14
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,934.86
|
|
|
PR LARYNGOPLASTY LARYNGEAL STEN W/STENT 12 YRS >
|
Professional
|
Both
|
$7,280.49
|
|
|
Service Code
|
HCPCS 31554
|
| Min. Negotiated Rate |
$1,354.95 |
| Max. Negotiated Rate |
$4,355.19 |
| Rate for Payer: Cash Price |
$1,964.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,935.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,742.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,742.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,838.86
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,935.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,838.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,935.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,935.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,451.73
|
| Rate for Payer: Healthfirst Commercial |
$1,935.64
|
| Rate for Payer: Healthfirst Essential Plan |
$4,355.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,838.86
|
| Rate for Payer: Healthfirst QHP |
$1,935.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,354.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,935.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,645.29
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,354.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,935.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,451.73
|
| Rate for Payer: SOMOS Essential |
$1,451.73
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,935.64
|
|
|
PR LARYNGOPLASTY LARYN WEB W/KEEL STENT INSERTION
|
Professional
|
Both
|
$5,567.42
|
|
|
Service Code
|
HCPCS 31580
|
| Min. Negotiated Rate |
$1,037.11 |
| Max. Negotiated Rate |
$3,333.55 |
| Rate for Payer: Cash Price |
$1,502.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,481.58
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,333.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,333.42
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,407.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,481.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,407.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,481.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,481.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,111.18
|
| Rate for Payer: Healthfirst Commercial |
$1,481.58
|
| Rate for Payer: Healthfirst Essential Plan |
$3,333.55
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,407.50
|
| Rate for Payer: Healthfirst QHP |
$1,481.58
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,037.11
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,481.58
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,259.34
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,037.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,481.58
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,111.18
|
| Rate for Payer: SOMOS Essential |
$1,111.18
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,481.58
|
|
|
PR LARYNGOPLASTY MEDIALIZATION UNLIATERAL
|
Professional
|
Both
|
$4,772.11
|
|
|
Service Code
|
HCPCS 31591
|
| Min. Negotiated Rate |
$894.79 |
| Max. Negotiated Rate |
$2,876.11 |
| Rate for Payer: Cash Price |
$1,290.76
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,278.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,150.44
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,150.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,214.36
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,278.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,214.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,278.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,278.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$958.70
|
| Rate for Payer: Healthfirst Commercial |
$1,278.27
|
| Rate for Payer: Healthfirst Essential Plan |
$2,876.11
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,214.36
|
| Rate for Payer: Healthfirst QHP |
$1,278.27
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$894.79
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,278.27
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,086.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$894.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,278.27
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$958.70
|
| Rate for Payer: SOMOS Essential |
$958.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,278.27
|
|
|
PR LARYNGOPLASTY W/OPEN REDUCTION FRACTURE W/TRACHS
|
Professional
|
Both
|
$6,117.65
|
|
|
Service Code
|
HCPCS 31584
|
| Min. Negotiated Rate |
$1,136.87 |
| Max. Negotiated Rate |
$3,654.22 |
| Rate for Payer: Cash Price |
$1,650.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,624.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,461.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,461.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,542.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,624.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,542.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,624.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,624.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,218.08
|
| Rate for Payer: Healthfirst Commercial |
$1,624.10
|
| Rate for Payer: Healthfirst Essential Plan |
$3,654.22
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,542.89
|
| Rate for Payer: Healthfirst QHP |
$1,624.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,136.87
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,624.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,380.48
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,136.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,624.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,218.08
|
| Rate for Payer: SOMOS Essential |
$1,218.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,624.10
|
|
|
PR LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC
|
Professional
|
Both
|
$982.70
|
|
|
Service Code
|
HCPCS 31570
|
| Min. Negotiated Rate |
$184.69 |
| Max. Negotiated Rate |
$593.64 |
| Rate for Payer: Cash Price |
$265.51
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$263.84
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$237.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$237.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$250.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$263.84
|
| Rate for Payer: Fidelis Qualified Health Plan |
$250.65
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$263.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$263.84
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$197.88
|
| Rate for Payer: Healthfirst Commercial |
$263.84
|
| Rate for Payer: Healthfirst Essential Plan |
$593.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$250.65
|
| Rate for Payer: Healthfirst QHP |
$263.84
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$184.69
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$263.84
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$224.26
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$184.69
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$263.84
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$197.88
|
| Rate for Payer: SOMOS Essential |
$197.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$263.84
|
|
|
PR LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY
|
Professional
|
Both
|
$1,331.58
|
|
|
Service Code
|
HCPCS 31560
|
| Min. Negotiated Rate |
$249.72 |
| Max. Negotiated Rate |
$802.69 |
| Rate for Payer: Cash Price |
$358.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$356.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$321.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$321.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$338.91
|
| Rate for Payer: Fidelis Medicare Advantage |
$356.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$338.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$356.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$356.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$267.56
|
| Rate for Payer: Healthfirst Commercial |
$356.75
|
| Rate for Payer: Healthfirst Essential Plan |
$802.69
|
| Rate for Payer: Healthfirst Medicare Advantage |
$338.91
|
| Rate for Payer: Healthfirst QHP |
$356.75
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$249.72
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$356.75
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$303.24
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$249.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$356.75
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$267.56
|
| Rate for Payer: SOMOS Essential |
$267.56
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$356.75
|
|
|
PR LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY
|
Professional
|
Both
|
$803.67
|
|
|
Service Code
|
HCPCS 31535
|
| Min. Negotiated Rate |
$152.67 |
| Max. Negotiated Rate |
$490.73 |
| Rate for Payer: Cash Price |
$218.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$218.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$196.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$196.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$207.19
|
| Rate for Payer: Fidelis Medicare Advantage |
$218.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$207.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$218.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$218.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$163.57
|
| Rate for Payer: Healthfirst Commercial |
$218.10
|
| Rate for Payer: Healthfirst Essential Plan |
$490.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$207.19
|
| Rate for Payer: Healthfirst QHP |
$218.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$152.67
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$218.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$185.38
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$152.67
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$218.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$163.57
|
| Rate for Payer: SOMOS Essential |
$163.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$218.10
|
|
|
PR LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT
|
Professional
|
Both
|
$1,031.07
|
|
|
Service Code
|
HCPCS 31540
|
| Min. Negotiated Rate |
$193.24 |
| Max. Negotiated Rate |
$621.13 |
| Rate for Payer: Cash Price |
$277.88
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$276.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$248.45
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$248.45
|
| Rate for Payer: Fidelis Essential Plan QHP |
$262.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$276.06
|
| Rate for Payer: Fidelis Qualified Health Plan |
$262.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$276.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$276.06
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$207.04
|
| Rate for Payer: Healthfirst Commercial |
$276.06
|
| Rate for Payer: Healthfirst Essential Plan |
$621.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$262.26
|
| Rate for Payer: Healthfirst QHP |
$276.06
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$193.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$276.06
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$234.65
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$193.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$276.06
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$207.04
|
| Rate for Payer: SOMOS Essential |
$207.04
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$276.06
|
|
|
PR LARYNGOSCOPY FLEXIBLE ABLATJ DESTJ LESION(S) UNI
|
Professional
|
Both
|
$772.10
|
|
|
Service Code
|
HCPCS 31572
|
| Min. Negotiated Rate |
$145.43 |
| Max. Negotiated Rate |
$467.44 |
| Rate for Payer: Cash Price |
$208.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$207.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$186.97
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$186.97
|
| Rate for Payer: Fidelis Essential Plan QHP |
$197.36
|
| Rate for Payer: Fidelis Medicare Advantage |
$207.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$197.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$207.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$207.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$155.81
|
| Rate for Payer: Healthfirst Commercial |
$207.75
|
| Rate for Payer: Healthfirst Essential Plan |
$467.44
|
| Rate for Payer: Healthfirst Medicare Advantage |
$197.36
|
| Rate for Payer: Healthfirst QHP |
$207.75
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$145.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$207.75
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$176.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$145.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$207.75
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$155.81
|
| Rate for Payer: SOMOS Essential |
$155.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$207.75
|
|
|
PR LARYNGOSCOPY FLEXIBLE DIAGNOSTIC
|
Professional
|
Both
|
$292.60
|
|
|
Service Code
|
HCPCS 31575
|
| Min. Negotiated Rate |
$56.33 |
| Max. Negotiated Rate |
$181.06 |
| Rate for Payer: Cash Price |
$80.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$80.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$72.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$72.42
|
| Rate for Payer: Fidelis Essential Plan QHP |
$76.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$80.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$76.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$80.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$80.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$60.35
|
| Rate for Payer: Healthfirst Commercial |
$80.47
|
| Rate for Payer: Healthfirst Essential Plan |
$181.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$76.45
|
| Rate for Payer: Healthfirst QHP |
$80.47
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$56.33
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$80.47
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$68.40
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$56.33
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$80.47
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$60.35
|
| Rate for Payer: SOMOS Essential |
$60.35
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$80.47
|
|
|
PR LARYNGOSCOPY FLEXIBLE RMVL LESION(S) NON-LASER
|
Professional
|
Both
|
$638.75
|
|
|
Service Code
|
HCPCS 31578
|
| Min. Negotiated Rate |
$120.36 |
| Max. Negotiated Rate |
$386.89 |
| Rate for Payer: Cash Price |
$173.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$171.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$154.75
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$154.75
|
| Rate for Payer: Fidelis Essential Plan QHP |
$163.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$171.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$163.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$171.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$171.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$128.96
|
| Rate for Payer: Healthfirst Commercial |
$171.95
|
| Rate for Payer: Healthfirst Essential Plan |
$386.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$163.35
|
| Rate for Payer: Healthfirst QHP |
$171.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$120.36
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$171.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$146.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$120.36
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$171.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$128.96
|
| Rate for Payer: SOMOS Essential |
$128.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$171.95
|
|
|
PR LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI
|
Professional
|
Both
|
$637.32
|
|
|
Service Code
|
HCPCS 31573
|
| Min. Negotiated Rate |
$119.66 |
| Max. Negotiated Rate |
$384.62 |
| Rate for Payer: Cash Price |
$172.26
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$170.94
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$153.85
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$153.85
|
| Rate for Payer: Fidelis Essential Plan QHP |
$162.39
|
| Rate for Payer: Fidelis Medicare Advantage |
$170.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$162.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$170.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$170.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$128.21
|
| Rate for Payer: Healthfirst Commercial |
$170.94
|
| Rate for Payer: Healthfirst Essential Plan |
$384.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$162.39
|
| Rate for Payer: Healthfirst QHP |
$170.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$119.66
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$170.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$145.30
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$119.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$170.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$128.21
|
| Rate for Payer: SOMOS Essential |
$128.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$170.94
|
|
|
PR LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES)
|
Professional
|
Both
|
$507.68
|
|
|
Service Code
|
HCPCS 31576
|
| Min. Negotiated Rate |
$96.82 |
| Max. Negotiated Rate |
$311.20 |
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$138.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$124.48
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$124.48
|
| Rate for Payer: Fidelis Essential Plan QHP |
$131.39
|
| Rate for Payer: Fidelis Medicare Advantage |
$138.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$131.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$138.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$138.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$103.73
|
| Rate for Payer: Healthfirst Commercial |
$138.31
|
| Rate for Payer: Healthfirst Essential Plan |
$311.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$131.39
|
| Rate for Payer: Healthfirst QHP |
$138.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$96.82
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$138.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$117.56
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$96.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$138.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$103.73
|
| Rate for Payer: SOMOS Essential |
$103.73
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$138.31
|
|
|
PR LARYNGOSCOPY FLEXIBLE W/INJECTION AGMNTJ UNI
|
Professional
|
Both
|
$638.75
|
|
|
Service Code
|
HCPCS 31574
|
| Min. Negotiated Rate |
$120.36 |
| Max. Negotiated Rate |
$386.89 |
| Rate for Payer: Cash Price |
$173.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$171.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$154.75
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$154.75
|
| Rate for Payer: Fidelis Essential Plan QHP |
$163.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$171.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$163.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$171.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$171.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$128.96
|
| Rate for Payer: Healthfirst Commercial |
$171.95
|
| Rate for Payer: Healthfirst Essential Plan |
$386.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$163.35
|
| Rate for Payer: Healthfirst QHP |
$171.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$120.36
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$171.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$146.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$120.36
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$171.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$128.96
|
| Rate for Payer: SOMOS Essential |
$128.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$171.95
|
|
