|
PR ORBITOTOMY W/O BONE FLAP W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$4,071.45
|
|
|
Service Code
|
HCPCS 67413
|
| Min. Negotiated Rate |
$752.15 |
| Max. Negotiated Rate |
$2,417.62 |
| Rate for Payer: Cash Price |
$1,104.13
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,074.50
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$967.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$967.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,020.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,074.50
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,020.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,074.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,074.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$805.88
|
| Rate for Payer: Healthfirst Commercial |
$1,074.50
|
| Rate for Payer: Healthfirst Essential Plan |
$2,417.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,020.77
|
| Rate for Payer: Healthfirst QHP |
$1,074.50
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$752.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,074.50
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$913.33
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$752.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,074.50
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$805.88
|
| Rate for Payer: SOMOS Essential |
$805.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,074.50
|
|
|
PR ORCHIECTOMY PARTIAL
|
Professional
|
Both
|
$2,464.42
|
|
|
Service Code
|
HCPCS 54522
|
| Min. Negotiated Rate |
$470.26 |
| Max. Negotiated Rate |
$1,511.55 |
| Rate for Payer: Cash Price |
$675.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$671.80
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$604.62
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$604.62
|
| Rate for Payer: Fidelis Essential Plan QHP |
$638.21
|
| Rate for Payer: Fidelis Medicare Advantage |
$671.80
|
| Rate for Payer: Fidelis Qualified Health Plan |
$638.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$671.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$671.80
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$503.85
|
| Rate for Payer: Healthfirst Commercial |
$671.80
|
| Rate for Payer: Healthfirst Essential Plan |
$1,511.55
|
| Rate for Payer: Healthfirst Medicare Advantage |
$638.21
|
| Rate for Payer: Healthfirst QHP |
$671.80
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$470.26
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$671.80
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$571.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$470.26
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$671.80
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$503.85
|
| Rate for Payer: SOMOS Essential |
$503.85
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$671.80
|
|
|
PR ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH
|
Professional
|
Both
|
$2,148.86
|
|
|
Service Code
|
HCPCS 54530
|
| Min. Negotiated Rate |
$410.07 |
| Max. Negotiated Rate |
$1,318.10 |
| Rate for Payer: Cash Price |
$588.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$585.82
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$527.24
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$527.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$556.53
|
| Rate for Payer: Fidelis Medicare Advantage |
$585.82
|
| Rate for Payer: Fidelis Qualified Health Plan |
$556.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$585.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$585.82
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$439.37
|
| Rate for Payer: Healthfirst Commercial |
$585.82
|
| Rate for Payer: Healthfirst Essential Plan |
$1,318.10
|
| Rate for Payer: Healthfirst Medicare Advantage |
$556.53
|
| Rate for Payer: Healthfirst QHP |
$585.82
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$410.07
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$585.82
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$497.95
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$410.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$585.82
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$439.37
|
| Rate for Payer: SOMOS Essential |
$439.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$585.82
|
|
|
PR ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL
|
Professional
|
Both
|
$3,116.72
|
|
|
Service Code
|
HCPCS 54535
|
| Min. Negotiated Rate |
$593.64 |
| Max. Negotiated Rate |
$1,908.13 |
| Rate for Payer: Cash Price |
$853.84
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$848.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$763.25
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$763.25
|
| Rate for Payer: Fidelis Essential Plan QHP |
$805.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$848.06
|
| Rate for Payer: Fidelis Qualified Health Plan |
$805.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$848.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$848.06
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$636.04
|
| Rate for Payer: Healthfirst Commercial |
$848.06
|
| Rate for Payer: Healthfirst Essential Plan |
$1,908.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$805.66
|
| Rate for Payer: Healthfirst QHP |
$848.06
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$593.64
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$848.06
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$720.85
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$593.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$848.06
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$636.04
|
| Rate for Payer: SOMOS Essential |
$636.04
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$848.06
|
|
|
PR ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH
|
Professional
|
Both
|
$1,390.24
|
|
|
Service Code
|
HCPCS 54520
|
| Min. Negotiated Rate |
$265.58 |
| Max. Negotiated Rate |
$853.65 |
| Rate for Payer: Cash Price |
$381.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$379.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$341.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$341.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$360.43
|
| Rate for Payer: Fidelis Medicare Advantage |
$379.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$360.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$379.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$379.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$284.55
|
| Rate for Payer: Healthfirst Commercial |
$379.40
|
| Rate for Payer: Healthfirst Essential Plan |
$853.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$360.43
|
| Rate for Payer: Healthfirst QHP |
$379.40
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$265.58
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$379.40
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$322.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$265.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$379.40
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$284.55
|
| Rate for Payer: SOMOS Essential |
$284.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$379.40
|
|
|
PR ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS
|
Professional
|
Both
|
$2,988.90
|
|
|
Service Code
|
HCPCS 54650
|
| Min. Negotiated Rate |
$569.64 |
| Max. Negotiated Rate |
$1,830.98 |
| Rate for Payer: Cash Price |
$819.13
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$813.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$732.39
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$732.39
|
| Rate for Payer: Fidelis Essential Plan QHP |
$773.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$813.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$773.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$813.77
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$813.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$610.33
|
| Rate for Payer: Healthfirst Commercial |
$813.77
|
| Rate for Payer: Healthfirst Essential Plan |
$1,830.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$773.08
|
| Rate for Payer: Healthfirst QHP |
$813.77
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$569.64
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$813.77
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$691.70
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$569.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$813.77
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$610.33
|
| Rate for Payer: SOMOS Essential |
$610.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$813.77
|
|
|
PR ORCHIOPEXY INGUINAL OR SCROTAL APPROACH
|
Professional
|
Both
|
$1,818.50
|
|
|
Service Code
|
HCPCS 54640
|
| Min. Negotiated Rate |
$347.33 |
| Max. Negotiated Rate |
$1,116.40 |
| Rate for Payer: Cash Price |
$497.24
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$496.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$446.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$446.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$471.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$496.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$471.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$496.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$496.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$372.13
|
| Rate for Payer: Healthfirst Commercial |
$496.18
|
| Rate for Payer: Healthfirst Essential Plan |
$1,116.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$471.37
|
| Rate for Payer: Healthfirst QHP |
$496.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$347.33
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$496.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$421.75
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$347.33
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$496.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$372.13
|
| Rate for Payer: SOMOS Essential |
$372.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$496.18
|
|
|
PR ORTHOPTIC TRAINING PERFORMED BY PHYS/OTHER QHP
|
Professional
|
Both
|
$127.61
|
|
|
Service Code
|
HCPCS 92065 26
|
| Min. Negotiated Rate |
$31.66 |
| Max. Negotiated Rate |
$31.66 |
| Rate for Payer: Amida Care Medicaid |
$31.66
|
|
|
PR ORTHOPTIC TRAINING PERFORMED BY PHYS/OTHER QHP
|
Professional
|
Both
|
$164.85
|
|
|
Service Code
|
HCPCS 92065
|
| Min. Negotiated Rate |
$24.35 |
| Max. Negotiated Rate |
$78.25 |
| Rate for Payer: Amida Care Medicaid |
$31.66
|
| Rate for Payer: Cash Price |
$35.99
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$34.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$31.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$31.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$33.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$34.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$33.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$34.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26.09
|
| Rate for Payer: Healthfirst Commercial |
$34.78
|
| Rate for Payer: Healthfirst Essential Plan |
$78.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$33.04
|
| Rate for Payer: Healthfirst QHP |
$34.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$24.35
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$34.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$29.56
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$24.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$34.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26.09
|
| Rate for Payer: SOMOS Essential |
$26.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$34.78
|
|
|
PR ORTHOPTIC TRAINING PERFORMED BY PHYS/OTHER QHP
|
Professional
|
Both
|
$37.24
|
|
|
Service Code
|
HCPCS 92065 TC
|
| Min. Negotiated Rate |
$31.66 |
| Max. Negotiated Rate |
$31.66 |
| Rate for Payer: Amida Care Medicaid |
$31.66
|
|
|
PR ORTHOPTIC TRAINING UNDER SUPERVISION OF PHYS/QHP
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
HCPCS 92066
|
| Min. Negotiated Rate |
$21.90 |
| Max. Negotiated Rate |
$70.38 |
| Rate for Payer: Cash Price |
$31.27
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$31.28
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$28.15
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$28.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$29.72
|
| Rate for Payer: Fidelis Medicare Advantage |
$31.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$29.72
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$31.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$31.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23.46
|
| Rate for Payer: Healthfirst Commercial |
$31.28
|
| Rate for Payer: Healthfirst Essential Plan |
$70.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$29.72
|
| Rate for Payer: Healthfirst QHP |
$31.28
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$21.90
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$31.28
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$26.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$21.90
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$31.28
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23.46
|
| Rate for Payer: SOMOS Essential |
$23.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$31.28
|
|
|
PR ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS
|
Professional
|
Both
|
$200.48
|
|
|
Service Code
|
HCPCS 97760
|
| Min. Negotiated Rate |
$37.22 |
| Max. Negotiated Rate |
$119.63 |
| Rate for Payer: Cash Price |
$54.21
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$53.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$47.85
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$47.85
|
| Rate for Payer: Fidelis Essential Plan QHP |
$50.51
|
| Rate for Payer: Fidelis Medicare Advantage |
$53.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$50.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$53.17
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$53.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$39.88
|
| Rate for Payer: Healthfirst Commercial |
$53.17
|
| Rate for Payer: Healthfirst Essential Plan |
$119.63
|
| Rate for Payer: Healthfirst Medicare Advantage |
$50.51
|
| Rate for Payer: Healthfirst QHP |
$53.17
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$37.22
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$53.17
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$45.19
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$37.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$53.17
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$39.88
|
| Rate for Payer: SOMOS Essential |
$39.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$53.17
|
|
|
PR ORTHOTICS/PROSTH MGMT &/TRAING SBSQ ENCTR 15 MIN
|
Professional
|
Both
|
$220.99
|
|
|
Service Code
|
HCPCS 97763
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$131.18 |
| Rate for Payer: Cash Price |
$59.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$58.30
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$52.47
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$52.47
|
| Rate for Payer: Fidelis Essential Plan QHP |
$55.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$58.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$55.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$58.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$58.30
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$43.73
|
| Rate for Payer: Healthfirst Commercial |
$58.30
|
| Rate for Payer: Healthfirst Essential Plan |
$131.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$55.38
|
| Rate for Payer: Healthfirst QHP |
$58.30
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$40.81
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$58.30
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$49.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$40.81
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$58.30
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$43.73
|
| Rate for Payer: SOMOS Essential |
$43.73
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$58.30
|
|
|
PR OSCILLATING TRACKING TEST W/RECORDING
|
Professional
|
Both
|
$52.75
|
|
|
Service Code
|
HCPCS 92545 26
|
| Min. Negotiated Rate |
$10.26 |
| Max. Negotiated Rate |
$34.66 |
| Rate for Payer: Amida Care Medicaid |
$34.66
|
| Rate for Payer: Cash Price |
$14.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$14.66
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$13.19
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$13.19
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$14.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.66
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$10.99
|
| Rate for Payer: Healthfirst Commercial |
$14.66
|
| Rate for Payer: Healthfirst Essential Plan |
$32.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13.93
|
| Rate for Payer: Healthfirst QHP |
$14.66
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$10.26
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$14.66
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$12.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$10.26
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$14.66
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$10.99
|
| Rate for Payer: SOMOS Essential |
$10.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$14.66
|
|
|
PR OSCILLATING TRACKING TEST W/RECORDING
|
Professional
|
Both
|
$17.12
|
|
|
Service Code
|
HCPCS 92545 TC
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$34.66 |
| Rate for Payer: Amida Care Medicaid |
$34.66
|
| Rate for Payer: Cash Price |
$4.56
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4.50
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$4.50
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3.38
|
| Rate for Payer: Healthfirst Commercial |
$4.50
|
| Rate for Payer: Healthfirst Essential Plan |
$10.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$4.28
|
| Rate for Payer: Healthfirst QHP |
$4.50
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$3.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$4.50
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$3.83
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$3.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4.50
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3.38
|
| Rate for Payer: SOMOS Essential |
$3.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4.50
|
|
|
PR OSCILLATING TRACKING TEST W/RECORDING
|
Professional
|
Both
|
$69.86
|
|
|
Service Code
|
HCPCS 92545
|
| Min. Negotiated Rate |
$13.41 |
| Max. Negotiated Rate |
$43.11 |
| Rate for Payer: Amida Care Medicaid |
$34.66
|
| Rate for Payer: Cash Price |
$19.01
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$19.16
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17.24
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$17.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$18.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$19.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$18.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$19.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$14.37
|
| Rate for Payer: Healthfirst Commercial |
$19.16
|
| Rate for Payer: Healthfirst Essential Plan |
$43.11
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18.20
|
| Rate for Payer: Healthfirst QHP |
$19.16
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$13.41
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$19.16
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$16.29
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$13.41
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$19.16
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$14.37
|
| Rate for Payer: SOMOS Essential |
$14.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$19.16
|
|
|
PROSTATITIS
|
Facility
|
OP
|
$207.82
|
|
|
Service Code
|
EAPG 00743
|
| Min. Negotiated Rate |
$150.43 |
| Max. Negotiated Rate |
$207.82 |
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$150.43
|
| Rate for Payer: Healthfirst Commercial |
$207.82
|
|
|
PR OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC
|
Professional
|
Both
|
$3,583.55
|
|
|
Service Code
|
HCPCS 28114
|
| Min. Negotiated Rate |
$685.14 |
| Max. Negotiated Rate |
$2,202.23 |
| Rate for Payer: Cash Price |
$979.41
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$978.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$880.89
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$880.89
|
| Rate for Payer: Fidelis Essential Plan QHP |
$929.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$978.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$929.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$978.77
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$978.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$734.08
|
| Rate for Payer: Healthfirst Commercial |
$978.77
|
| Rate for Payer: Healthfirst Essential Plan |
$2,202.23
|
| Rate for Payer: Healthfirst Medicare Advantage |
$929.83
|
| Rate for Payer: Healthfirst QHP |
$978.77
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$685.14
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$978.77
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$831.95
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$685.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$978.77
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$734.08
|
| Rate for Payer: SOMOS Essential |
$734.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$978.77
|
|
|
PR OSTC PRTL EXOSTC/CONDYLC METAR HEAD
|
Professional
|
Both
|
$1,836.03
|
|
|
Service Code
|
HCPCS 28288
|
| Min. Negotiated Rate |
$353.00 |
| Max. Negotiated Rate |
$1,134.65 |
| Rate for Payer: Cash Price |
$507.82
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$504.29
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$453.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$453.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$479.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$504.29
|
| Rate for Payer: Fidelis Qualified Health Plan |
$479.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$504.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$504.29
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$378.22
|
| Rate for Payer: Healthfirst Commercial |
$504.29
|
| Rate for Payer: Healthfirst Essential Plan |
$1,134.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$479.08
|
| Rate for Payer: Healthfirst QHP |
$504.29
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$353.00
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$504.29
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$428.65
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$353.00
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$504.29
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$378.22
|
| Rate for Payer: SOMOS Essential |
$378.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$504.29
|
|
|
PR OSTECTOMY CALCANEUS
|
Professional
|
Both
|
$1,796.10
|
|
|
Service Code
|
HCPCS 28118
|
| Min. Negotiated Rate |
$347.14 |
| Max. Negotiated Rate |
$1,115.82 |
| Rate for Payer: Cash Price |
$495.73
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$495.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$446.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$446.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$471.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$495.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$471.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$495.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$495.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$371.94
|
| Rate for Payer: Healthfirst Commercial |
$495.92
|
| Rate for Payer: Healthfirst Essential Plan |
$1,115.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$471.12
|
| Rate for Payer: Healthfirst QHP |
$495.92
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$347.14
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$495.92
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$421.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$347.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$495.92
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$371.94
|
| Rate for Payer: SOMOS Essential |
$371.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$495.92
|
|
|
PR OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS
|
Professional
|
Both
|
$1,528.10
|
|
|
Service Code
|
HCPCS 28119
|
| Min. Negotiated Rate |
$294.76 |
| Max. Negotiated Rate |
$947.43 |
| Rate for Payer: Cash Price |
$422.88
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$421.08
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$378.97
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$378.97
|
| Rate for Payer: Fidelis Essential Plan QHP |
$400.03
|
| Rate for Payer: Fidelis Medicare Advantage |
$421.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$400.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$421.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$421.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$315.81
|
| Rate for Payer: Healthfirst Commercial |
$421.08
|
| Rate for Payer: Healthfirst Essential Plan |
$947.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$400.03
|
| Rate for Payer: Healthfirst QHP |
$421.08
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$294.76
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$421.08
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$357.92
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$294.76
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$421.08
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$315.81
|
| Rate for Payer: SOMOS Essential |
$315.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$421.08
|
|
|
PR OSTECTOMY COMPLETE 1ST METATARSAL HEAD
|
Professional
|
Both
|
$1,343.48
|
|
|
Service Code
|
HCPCS 28111
|
| Min. Negotiated Rate |
$256.46 |
| Max. Negotiated Rate |
$824.33 |
| Rate for Payer: Cash Price |
$368.13
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$366.37
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$329.73
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$329.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$348.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$366.37
|
| Rate for Payer: Fidelis Qualified Health Plan |
$348.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$366.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$366.37
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$274.78
|
| Rate for Payer: Healthfirst Commercial |
$366.37
|
| Rate for Payer: Healthfirst Essential Plan |
$824.33
|
| Rate for Payer: Healthfirst Medicare Advantage |
$348.05
|
| Rate for Payer: Healthfirst QHP |
$366.37
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$256.46
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$366.37
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$311.41
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$256.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$366.37
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$274.78
|
| Rate for Payer: SOMOS Essential |
$274.78
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$366.37
|
|
|
PR OSTECTOMY COMPLETE 5TH METATARSAL HEAD
|
Professional
|
Both
|
$1,790.64
|
|
|
Service Code
|
HCPCS 28113
|
| Min. Negotiated Rate |
$346.65 |
| Max. Negotiated Rate |
$1,114.24 |
| Rate for Payer: Cash Price |
$494.79
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$495.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$445.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$445.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$470.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$495.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$470.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$495.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$495.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$371.42
|
| Rate for Payer: Healthfirst Commercial |
$495.22
|
| Rate for Payer: Healthfirst Essential Plan |
$1,114.24
|
| Rate for Payer: Healthfirst Medicare Advantage |
$470.46
|
| Rate for Payer: Healthfirst QHP |
$495.22
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$346.65
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$495.22
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$420.94
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$346.65
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$495.22
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$371.42
|
| Rate for Payer: SOMOS Essential |
$371.42
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$495.22
|
|
|
PR OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4
|
Professional
|
Both
|
$1,326.08
|
|
|
Service Code
|
HCPCS 28112
|
| Min. Negotiated Rate |
$254.46 |
| Max. Negotiated Rate |
$817.92 |
| Rate for Payer: Cash Price |
$364.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$363.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$327.17
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$327.17
|
| Rate for Payer: Fidelis Essential Plan QHP |
$345.34
|
| Rate for Payer: Fidelis Medicare Advantage |
$363.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$345.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$363.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$363.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$272.64
|
| Rate for Payer: Healthfirst Commercial |
$363.52
|
| Rate for Payer: Healthfirst Essential Plan |
$817.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$345.34
|
| Rate for Payer: Healthfirst QHP |
$363.52
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$254.46
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$363.52
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$308.99
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$254.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$363.52
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$272.64
|
| Rate for Payer: SOMOS Essential |
$272.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$363.52
|
|
|
PR OSTECTOMY PRTL 5TH METAR HEAD SPX
|
Professional
|
Both
|
$1,228.40
|
|
|
Service Code
|
HCPCS 28110
|
| Min. Negotiated Rate |
$240.30 |
| Max. Negotiated Rate |
$772.38 |
| Rate for Payer: Cash Price |
$341.69
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$343.28
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$308.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$308.95
|
| Rate for Payer: Fidelis Essential Plan QHP |
$326.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$343.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$326.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$343.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$343.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$257.46
|
| Rate for Payer: Healthfirst Commercial |
$343.28
|
| Rate for Payer: Healthfirst Essential Plan |
$772.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$326.12
|
| Rate for Payer: Healthfirst QHP |
$343.28
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$240.30
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$343.28
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$291.79
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$240.30
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$343.28
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$257.46
|
| Rate for Payer: SOMOS Essential |
$257.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$343.28
|
|
