|
PR NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER
|
Professional
|
Both
|
$599.87
|
|
|
Service Code
|
HCPCS 95872 26
|
| Min. Negotiated Rate |
$111.97 |
| Max. Negotiated Rate |
$359.89 |
| Rate for Payer: Amida Care Medicaid |
$122.43
|
| Rate for Payer: Cash Price |
$161.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$159.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$143.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$143.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$151.95
|
| Rate for Payer: Fidelis Medicare Advantage |
$159.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$151.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$159.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$159.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$119.96
|
| Rate for Payer: Healthfirst Commercial |
$159.95
|
| Rate for Payer: Healthfirst Essential Plan |
$359.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$151.95
|
| Rate for Payer: Healthfirst QHP |
$159.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$111.97
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$159.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$135.96
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$111.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$159.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$119.96
|
| Rate for Payer: SOMOS Essential |
$119.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$159.95
|
|
|
PR NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER
|
Professional
|
Both
|
$215.50
|
|
|
Service Code
|
HCPCS 95872 TC
|
| Min. Negotiated Rate |
$30.86 |
| Max. Negotiated Rate |
$122.43 |
| Rate for Payer: Amida Care Medicaid |
$122.43
|
| Rate for Payer: Cash Price |
$50.13
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$44.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$39.68
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$39.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$41.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$44.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$41.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$44.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$44.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$33.07
|
| Rate for Payer: Healthfirst Commercial |
$44.09
|
| Rate for Payer: Healthfirst Essential Plan |
$99.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$41.89
|
| Rate for Payer: Healthfirst QHP |
$44.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$30.86
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$44.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$37.48
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$30.86
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$44.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$33.07
|
| Rate for Payer: SOMOS Essential |
$33.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$44.09
|
|
|
PR NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES
|
Professional
|
Both
|
$58.63
|
|
|
Service Code
|
HCPCS 20560
|
| Min. Negotiated Rate |
$11.57 |
| Max. Negotiated Rate |
$37.19 |
| Rate for Payer: Cash Price |
$16.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$16.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$14.88
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$14.88
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$16.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.40
|
| Rate for Payer: Healthfirst Commercial |
$16.53
|
| Rate for Payer: Healthfirst Essential Plan |
$37.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.70
|
| Rate for Payer: Healthfirst QHP |
$16.53
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$11.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$16.53
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$14.05
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$11.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$16.53
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$12.40
|
| Rate for Payer: SOMOS Essential |
$12.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16.53
|
|
|
PR NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES
|
Professional
|
Both
|
$88.59
|
|
|
Service Code
|
HCPCS 20561
|
| Min. Negotiated Rate |
$17.49 |
| Max. Negotiated Rate |
$56.23 |
| Rate for Payer: Cash Price |
$24.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$24.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22.49
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$22.49
|
| Rate for Payer: Fidelis Essential Plan QHP |
$23.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$24.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$24.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$24.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18.74
|
| Rate for Payer: Healthfirst Commercial |
$24.99
|
| Rate for Payer: Healthfirst Essential Plan |
$56.23
|
| Rate for Payer: Healthfirst Medicare Advantage |
$23.74
|
| Rate for Payer: Healthfirst QHP |
$24.99
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$17.49
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$24.99
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$21.24
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$17.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$24.99
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18.74
|
| Rate for Payer: SOMOS Essential |
$18.74
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$24.99
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME <= 50 SQ CM
|
Professional
|
Both
|
$96.08
|
|
|
Service Code
|
HCPCS 97605
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$58.86 |
| Rate for Payer: Cash Price |
$26.09
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$26.16
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$23.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$24.85
|
| Rate for Payer: Fidelis Medicare Advantage |
$26.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24.85
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19.62
|
| Rate for Payer: Healthfirst Commercial |
$26.16
|
| Rate for Payer: Healthfirst Essential Plan |
$58.86
|
| Rate for Payer: Healthfirst Medicare Advantage |
$24.85
|
| Rate for Payer: Healthfirst QHP |
$26.16
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$18.31
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$26.16
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$22.24
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$18.31
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26.16
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19.62
|
| Rate for Payer: SOMOS Essential |
$19.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26.16
|
|
|
PR NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM
|
Professional
|
Both
|
$103.78
|
|
|
Service Code
|
HCPCS 97606
|
| Min. Negotiated Rate |
$19.79 |
| Max. Negotiated Rate |
$63.61 |
| Rate for Payer: Cash Price |
$28.62
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$28.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$25.44
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$25.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$26.86
|
| Rate for Payer: Fidelis Medicare Advantage |
$28.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$26.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$28.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$28.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$21.20
|
| Rate for Payer: Healthfirst Commercial |
$28.27
|
| Rate for Payer: Healthfirst Essential Plan |
$63.61
|
| Rate for Payer: Healthfirst Medicare Advantage |
$26.86
|
| Rate for Payer: Healthfirst QHP |
$28.27
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$19.79
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$28.27
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$24.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$19.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$28.27
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$21.20
|
| Rate for Payer: SOMOS Essential |
$21.20
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$28.27
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME <= 50 SQ CM
|
Professional
|
Both
|
$94.96
|
|
|
Service Code
|
HCPCS 97607
|
| Min. Negotiated Rate |
$16.67 |
| Max. Negotiated Rate |
$53.57 |
| Rate for Payer: Cash Price |
$24.34
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$23.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21.43
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$21.43
|
| Rate for Payer: Fidelis Essential Plan QHP |
$22.62
|
| Rate for Payer: Fidelis Medicare Advantage |
$23.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$23.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.86
|
| Rate for Payer: Healthfirst Commercial |
$23.81
|
| Rate for Payer: Healthfirst Essential Plan |
$53.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22.62
|
| Rate for Payer: Healthfirst QHP |
$23.81
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$16.67
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$23.81
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$20.24
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$16.67
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$23.81
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$17.86
|
| Rate for Payer: SOMOS Essential |
$17.86
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$23.81
|
|
|
PR NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM
|
Professional
|
Both
|
$112.28
|
|
|
Service Code
|
HCPCS 97608
|
| Min. Negotiated Rate |
$19.72 |
| Max. Negotiated Rate |
$63.38 |
| Rate for Payer: Cash Price |
$29.14
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$28.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$25.35
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$25.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$26.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$28.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$26.76
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$28.17
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$28.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$21.13
|
| Rate for Payer: Healthfirst Commercial |
$28.17
|
| Rate for Payer: Healthfirst Essential Plan |
$63.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$26.76
|
| Rate for Payer: Healthfirst QHP |
$28.17
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$19.72
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$28.17
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$23.94
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$19.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$28.17
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$21.13
|
| Rate for Payer: SOMOS Essential |
$21.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$28.17
|
|
|
PR NEPHRECTOMY PARTIAL
|
Professional
|
Both
|
$5,548.20
|
|
|
Service Code
|
HCPCS 50240
|
| Min. Negotiated Rate |
$1,055.42 |
| Max. Negotiated Rate |
$3,392.41 |
| Rate for Payer: Cash Price |
$1,518.41
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,507.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,356.97
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,356.97
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,432.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,507.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,432.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,507.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,507.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,130.81
|
| Rate for Payer: Healthfirst Commercial |
$1,507.74
|
| Rate for Payer: Healthfirst Essential Plan |
$3,392.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,432.35
|
| Rate for Payer: Healthfirst QHP |
$1,507.74
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,055.42
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,507.74
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,281.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,055.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,507.74
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,130.81
|
| Rate for Payer: SOMOS Essential |
$1,130.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,507.74
|
|
|
PR NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN
|
Professional
|
Both
|
$6,109.32
|
|
|
Service Code
|
HCPCS 50236
|
| Min. Negotiated Rate |
$1,157.46 |
| Max. Negotiated Rate |
$3,720.40 |
| Rate for Payer: Cash Price |
$1,665.58
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,653.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,488.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,488.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,570.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,653.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,570.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,653.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,653.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,240.13
|
| Rate for Payer: Healthfirst Commercial |
$1,653.51
|
| Rate for Payer: Healthfirst Essential Plan |
$3,720.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,570.83
|
| Rate for Payer: Healthfirst QHP |
$1,653.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,157.46
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,653.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,405.48
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,157.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,653.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,240.13
|
| Rate for Payer: SOMOS Essential |
$1,240.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,653.51
|
|
|
PR NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ
|
Professional
|
Both
|
$4,500.72
|
|
|
Service Code
|
HCPCS 50220
|
| Min. Negotiated Rate |
$853.40 |
| Max. Negotiated Rate |
$2,743.07 |
| Rate for Payer: Cash Price |
$1,219.14
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,219.14
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,097.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,097.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,158.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,219.14
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,158.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,219.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,219.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$914.36
|
| Rate for Payer: Healthfirst Commercial |
$1,219.14
|
| Rate for Payer: Healthfirst Essential Plan |
$2,743.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,158.18
|
| Rate for Payer: Healthfirst QHP |
$1,219.14
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$853.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,219.14
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,036.27
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$853.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,219.14
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$914.36
|
| Rate for Payer: SOMOS Essential |
$914.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,219.14
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD
|
Professional
|
Both
|
$5,375.55
|
|
|
Service Code
|
HCPCS 50230
|
| Min. Negotiated Rate |
$1,017.11 |
| Max. Negotiated Rate |
$3,269.30 |
| Rate for Payer: Cash Price |
$1,463.17
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,453.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,307.72
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,307.72
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,380.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,453.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,380.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,453.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,453.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,089.77
|
| Rate for Payer: Healthfirst Commercial |
$1,453.02
|
| Rate for Payer: Healthfirst Essential Plan |
$3,269.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,380.37
|
| Rate for Payer: Healthfirst QHP |
$1,453.02
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,017.11
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,453.02
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,235.07
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,017.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,453.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,089.77
|
| Rate for Payer: SOMOS Essential |
$1,089.77
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,453.02
|
|
|
PR NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL
|
Professional
|
Both
|
$5,104.79
|
|
|
Service Code
|
HCPCS 50225
|
| Min. Negotiated Rate |
$939.81 |
| Max. Negotiated Rate |
$3,020.83 |
| Rate for Payer: Cash Price |
$1,396.64
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,342.59
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,208.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,208.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,275.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,342.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,275.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,342.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,342.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,006.94
|
| Rate for Payer: Healthfirst Commercial |
$1,342.59
|
| Rate for Payer: Healthfirst Essential Plan |
$3,020.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,275.46
|
| Rate for Payer: Healthfirst QHP |
$1,342.59
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$939.81
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,342.59
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,141.20
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$939.81
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,342.59
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,006.94
|
| Rate for Payer: SOMOS Essential |
$1,006.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,342.59
|
|
|
PR NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC
|
Professional
|
Both
|
$5,469.10
|
|
|
Service Code
|
HCPCS 50234
|
| Min. Negotiated Rate |
$1,033.30 |
| Max. Negotiated Rate |
$3,321.32 |
| Rate for Payer: Cash Price |
$1,483.84
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,476.14
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,328.53
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,328.53
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,402.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,476.14
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,402.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,476.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,476.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,107.11
|
| Rate for Payer: Healthfirst Commercial |
$1,476.14
|
| Rate for Payer: Healthfirst Essential Plan |
$3,321.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,402.33
|
| Rate for Payer: Healthfirst QHP |
$1,476.14
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,033.30
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,476.14
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,254.72
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,033.30
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,476.14
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,107.11
|
| Rate for Payer: SOMOS Essential |
$1,107.11
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,476.14
|
|
|
PR NEPHROLITHOTOMY COMP CGEN KDN ABNORMALITY
|
Professional
|
Both
|
$4,941.48
|
|
|
Service Code
|
HCPCS 50070
|
| Min. Negotiated Rate |
$938.81 |
| Max. Negotiated Rate |
$3,017.61 |
| Rate for Payer: Cash Price |
$1,349.08
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,341.16
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,207.04
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,207.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,274.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,341.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,274.10
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,341.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,341.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,005.87
|
| Rate for Payer: Healthfirst Commercial |
$1,341.16
|
| Rate for Payer: Healthfirst Essential Plan |
$3,017.61
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,274.10
|
| Rate for Payer: Healthfirst QHP |
$1,341.16
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$938.81
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,341.16
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,139.99
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$938.81
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,341.16
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,005.87
|
| Rate for Payer: SOMOS Essential |
$1,005.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,341.16
|
|
|
PR NEPHROLITHOTOMY REMOVAL STAGE 1
|
Professional
|
Both
|
$4,748.63
|
|
|
Service Code
|
HCPCS 50060
|
| Min. Negotiated Rate |
$902.09 |
| Max. Negotiated Rate |
$2,899.57 |
| Rate for Payer: Cash Price |
$1,298.24
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,288.70
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,159.83
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,159.83
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,224.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,288.70
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,224.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,288.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,288.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$966.52
|
| Rate for Payer: Healthfirst Commercial |
$1,288.70
|
| Rate for Payer: Healthfirst Essential Plan |
$2,899.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,224.27
|
| Rate for Payer: Healthfirst QHP |
$1,288.70
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$902.09
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,288.70
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,095.39
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$902.09
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,288.70
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$966.52
|
| Rate for Payer: SOMOS Essential |
$966.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,288.70
|
|
|
PR NEPHROLITHOTOMY RMVL LG STAGHORN STAGE 1
|
Professional
|
Both
|
$6,066.55
|
|
|
Service Code
|
HCPCS 50075
|
| Min. Negotiated Rate |
$1,151.78 |
| Max. Negotiated Rate |
$3,702.15 |
| Rate for Payer: Cash Price |
$1,656.73
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,645.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,480.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,480.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,563.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,645.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,563.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,645.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,645.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,234.05
|
| Rate for Payer: Healthfirst Commercial |
$1,645.40
|
| Rate for Payer: Healthfirst Essential Plan |
$3,702.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,563.13
|
| Rate for Payer: Healthfirst QHP |
$1,645.40
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,151.78
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,645.40
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,398.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,151.78
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,645.40
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,234.05
|
| Rate for Payer: SOMOS Essential |
$1,234.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,645.40
|
|
|
PR NEPHROLITHOTOMY SECONDARY FOR CALCULUS
|
Professional
|
Both
|
$5,038.32
|
|
|
Service Code
|
HCPCS 50065
|
| Min. Negotiated Rate |
$956.07 |
| Max. Negotiated Rate |
$3,073.07 |
| Rate for Payer: Cash Price |
$1,374.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,365.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,229.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,229.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,297.52
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,365.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,297.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,365.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,365.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,024.36
|
| Rate for Payer: Healthfirst Commercial |
$1,365.81
|
| Rate for Payer: Healthfirst Essential Plan |
$3,073.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,297.52
|
| Rate for Payer: Healthfirst QHP |
$1,365.81
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$956.07
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,365.81
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,160.94
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$956.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,365.81
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,024.36
|
| Rate for Payer: SOMOS Essential |
$1,024.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,365.81
|
|
|
PR NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY
|
Professional
|
Both
|
$5,555.31
|
|
|
Service Code
|
HCPCS 50500
|
| Min. Negotiated Rate |
$1,079.02 |
| Max. Negotiated Rate |
$3,468.28 |
| Rate for Payer: Cash Price |
$1,553.79
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,541.46
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,387.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,387.31
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,464.39
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,541.46
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,464.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,541.46
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,541.46
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,156.10
|
| Rate for Payer: Healthfirst Commercial |
$1,541.46
|
| Rate for Payer: Healthfirst Essential Plan |
$3,468.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,464.39
|
| Rate for Payer: Healthfirst QHP |
$1,541.46
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,079.02
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,541.46
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,310.24
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,079.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,541.46
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,156.10
|
| Rate for Payer: SOMOS Essential |
$1,156.10
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,541.46
|
|
|
PR NEPHROSTOMY/NEPHROTOMY W/DRAINAGE
|
Professional
|
Both
|
$3,868.45
|
|
|
Service Code
|
HCPCS 50040
|
| Min. Negotiated Rate |
$736.34 |
| Max. Negotiated Rate |
$2,366.82 |
| Rate for Payer: Cash Price |
$1,057.62
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,051.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$946.73
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$946.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$999.32
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,051.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$999.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,051.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,051.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$788.94
|
| Rate for Payer: Healthfirst Commercial |
$1,051.92
|
| Rate for Payer: Healthfirst Essential Plan |
$2,366.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$999.32
|
| Rate for Payer: Healthfirst QHP |
$1,051.92
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$736.34
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,051.92
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$894.13
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$736.34
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,051.92
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$788.94
|
| Rate for Payer: SOMOS Essential |
$788.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,051.92
|
|
|
PR NEPHROTOMY W/EXPLORATION
|
Professional
|
Both
|
$3,897.18
|
|
|
Service Code
|
HCPCS 50045
|
| Min. Negotiated Rate |
$741.94 |
| Max. Negotiated Rate |
$2,384.82 |
| Rate for Payer: Cash Price |
$1,065.33
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,059.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$953.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$953.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,006.92
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,059.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,006.92
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,059.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,059.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$794.94
|
| Rate for Payer: Healthfirst Commercial |
$1,059.92
|
| Rate for Payer: Healthfirst Essential Plan |
$2,384.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,006.92
|
| Rate for Payer: Healthfirst QHP |
$1,059.92
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$741.94
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,059.92
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$900.93
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$741.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,059.92
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$794.94
|
| Rate for Payer: SOMOS Essential |
$794.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,059.92
|
|
|
PR NERVE CONDUCTION STUDIES 11-12 STUDIES
|
Professional
|
Both
|
$619.89
|
|
|
Service Code
|
HCPCS 95912 26
|
| Min. Negotiated Rate |
$118.45 |
| Max. Negotiated Rate |
$380.75 |
| Rate for Payer: Amida Care Medicaid |
$165.14
|
| Rate for Payer: Cash Price |
$170.67
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$169.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$152.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$152.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$160.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$169.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$160.76
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$169.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$169.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$126.92
|
| Rate for Payer: Healthfirst Commercial |
$169.22
|
| Rate for Payer: Healthfirst Essential Plan |
$380.75
|
| Rate for Payer: Healthfirst Medicare Advantage |
$160.76
|
| Rate for Payer: Healthfirst QHP |
$169.22
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$118.45
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$169.22
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$143.84
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$118.45
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$169.22
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$126.92
|
| Rate for Payer: SOMOS Essential |
$126.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$169.22
|
|
|
PR NERVE CONDUCTION STUDIES 11-12 STUDIES
|
Professional
|
Both
|
$402.22
|
|
|
Service Code
|
HCPCS 95912 TC
|
| Min. Negotiated Rate |
$72.05 |
| Max. Negotiated Rate |
$231.59 |
| Rate for Payer: Amida Care Medicaid |
$165.14
|
| Rate for Payer: Cash Price |
$110.09
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$102.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$92.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$92.64
|
| Rate for Payer: Fidelis Essential Plan QHP |
$97.78
|
| Rate for Payer: Fidelis Medicare Advantage |
$102.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$97.78
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$102.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$102.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$77.20
|
| Rate for Payer: Healthfirst Commercial |
$102.93
|
| Rate for Payer: Healthfirst Essential Plan |
$231.59
|
| Rate for Payer: Healthfirst Medicare Advantage |
$97.78
|
| Rate for Payer: Healthfirst QHP |
$102.93
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$72.05
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$102.93
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$87.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$72.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$102.93
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$77.20
|
| Rate for Payer: SOMOS Essential |
$77.20
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$102.93
|
|
|
PR NERVE CONDUCTION STUDIES 11-12 STUDIES
|
Professional
|
Both
|
$1,022.11
|
|
|
Service Code
|
HCPCS 95912
|
| Min. Negotiated Rate |
$165.14 |
| Max. Negotiated Rate |
$612.34 |
| Rate for Payer: Amida Care Medicaid |
$165.14
|
| Rate for Payer: Cash Price |
$280.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$272.15
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$244.94
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$244.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$258.54
|
| Rate for Payer: Fidelis Medicare Advantage |
$272.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$258.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$272.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$272.15
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$204.11
|
| Rate for Payer: Healthfirst Commercial |
$272.15
|
| Rate for Payer: Healthfirst Essential Plan |
$612.34
|
| Rate for Payer: Healthfirst Medicare Advantage |
$258.54
|
| Rate for Payer: Healthfirst QHP |
$272.15
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$190.50
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$272.15
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$231.33
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$190.50
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$272.15
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$204.11
|
| Rate for Payer: SOMOS Essential |
$204.11
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$272.15
|
|
|
PR NERVE CONDUCTION STUDIES 1-2 STUDIES
|
Professional
|
Both
|
$208.08
|
|
|
Service Code
|
HCPCS 95907 26
|
| Min. Negotiated Rate |
$39.70 |
| Max. Negotiated Rate |
$127.62 |
| Rate for Payer: Amida Care Medicaid |
$59.95
|
| Rate for Payer: Cash Price |
$57.41
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$56.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$51.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$51.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$53.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$56.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$53.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$56.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$56.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$42.54
|
| Rate for Payer: Healthfirst Commercial |
$56.72
|
| Rate for Payer: Healthfirst Essential Plan |
$127.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$53.88
|
| Rate for Payer: Healthfirst QHP |
$56.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$39.70
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$56.72
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$48.21
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$39.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$56.72
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$42.54
|
| Rate for Payer: SOMOS Essential |
$42.54
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$56.72
|
|
