|
PR PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST
|
Professional
|
Both
|
$7,566.09
|
|
|
Service Code
|
HCPCS 48548
|
| Min. Negotiated Rate |
$1,396.49 |
| Max. Negotiated Rate |
$4,488.73 |
| Rate for Payer: Cash Price |
$2,013.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,994.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,795.49
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,795.49
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,895.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,994.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,895.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,994.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,994.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,496.24
|
| Rate for Payer: Healthfirst Commercial |
$1,994.99
|
| Rate for Payer: Healthfirst Essential Plan |
$4,488.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,895.24
|
| Rate for Payer: Healthfirst QHP |
$1,994.99
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,396.49
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,994.99
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,695.74
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,396.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,994.99
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,496.24
|
| Rate for Payer: SOMOS Essential |
$1,496.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,994.99
|
|
|
PR PANCREATORRHAPHY INJURY
|
Professional
|
Both
|
$6,096.55
|
|
|
Service Code
|
HCPCS 48545
|
| Min. Negotiated Rate |
$1,127.67 |
| Max. Negotiated Rate |
$3,624.66 |
| Rate for Payer: Cash Price |
$1,623.52
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,610.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,449.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,449.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,530.41
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,610.96
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,530.41
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,610.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,610.96
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,208.22
|
| Rate for Payer: Healthfirst Commercial |
$1,610.96
|
| Rate for Payer: Healthfirst Essential Plan |
$3,624.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,530.41
|
| Rate for Payer: Healthfirst QHP |
$1,610.96
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,127.67
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,610.96
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,369.32
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,127.67
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,610.96
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,208.22
|
| Rate for Payer: SOMOS Essential |
$1,208.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,610.96
|
|
|
PR PARACEN ANT CHAM RMVL BLOOD W/WO IRRIG&/AIR IN
|
Professional
|
Both
|
$1,960.07
|
|
|
Service Code
|
HCPCS 65815
|
| Min. Negotiated Rate |
$375.38 |
| Max. Negotiated Rate |
$1,206.56 |
| Rate for Payer: Cash Price |
$541.36
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$536.25
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$482.62
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$482.62
|
| Rate for Payer: Fidelis Essential Plan QHP |
$509.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$536.25
|
| Rate for Payer: Fidelis Qualified Health Plan |
$509.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$536.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$536.25
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$402.19
|
| Rate for Payer: Healthfirst Commercial |
$536.25
|
| Rate for Payer: Healthfirst Essential Plan |
$1,206.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$509.44
|
| Rate for Payer: Healthfirst QHP |
$536.25
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$375.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$536.25
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$455.81
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$375.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$536.25
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$402.19
|
| Rate for Payer: SOMOS Essential |
$402.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$536.25
|
|
|
PR PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX
|
Professional
|
Both
|
$362.46
|
|
|
Service Code
|
HCPCS 65800
|
| Min. Negotiated Rate |
$69.42 |
| Max. Negotiated Rate |
$223.13 |
| Rate for Payer: Cash Price |
$99.37
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$99.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$89.25
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$89.25
|
| Rate for Payer: Fidelis Essential Plan QHP |
$94.21
|
| Rate for Payer: Fidelis Medicare Advantage |
$99.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$94.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$99.17
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$99.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$74.38
|
| Rate for Payer: Healthfirst Commercial |
$99.17
|
| Rate for Payer: Healthfirst Essential Plan |
$223.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$94.21
|
| Rate for Payer: Healthfirst QHP |
$99.17
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$69.42
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$99.17
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$84.29
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$69.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$99.17
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$74.38
|
| Rate for Payer: SOMOS Essential |
$74.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$99.17
|
|
|
PR PARACENTSIS ANT CHAM RMVL VITREOUS W/WO AIR INJX
|
Professional
|
Both
|
$1,911.63
|
|
|
Service Code
|
HCPCS 65810
|
| Min. Negotiated Rate |
$364.90 |
| Max. Negotiated Rate |
$1,172.88 |
| Rate for Payer: Cash Price |
$527.78
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$521.28
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$469.15
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$469.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$495.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$521.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$495.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$521.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$521.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$390.96
|
| Rate for Payer: Healthfirst Commercial |
$521.28
|
| Rate for Payer: Healthfirst Essential Plan |
$1,172.88
|
| Rate for Payer: Healthfirst Medicare Advantage |
$495.22
|
| Rate for Payer: Healthfirst QHP |
$521.28
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$364.90
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$521.28
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$443.09
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$364.90
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$521.28
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$390.96
|
| Rate for Payer: SOMOS Essential |
$390.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$521.28
|
|
|
PR PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC
|
Professional
|
Both
|
$6,176.73
|
|
|
Service Code
|
HCPCS 60505
|
| Min. Negotiated Rate |
$1,124.96 |
| Max. Negotiated Rate |
$3,615.93 |
| Rate for Payer: Cash Price |
$1,658.46
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,607.08
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,446.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,446.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,526.73
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,607.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,526.73
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,607.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,607.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,205.31
|
| Rate for Payer: Healthfirst Commercial |
$1,607.08
|
| Rate for Payer: Healthfirst Essential Plan |
$3,615.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,526.73
|
| Rate for Payer: Healthfirst QHP |
$1,607.08
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,124.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,607.08
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,366.02
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,124.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,607.08
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,205.31
|
| Rate for Payer: SOMOS Essential |
$1,205.31
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,607.08
|
|
|
PR PARATHYROID AUTOTRANSPLANTATION ADD-ON
|
Professional
|
Both
|
$1,068.17
|
|
|
Service Code
|
HCPCS 60512
|
| Min. Negotiated Rate |
$196.12 |
| Max. Negotiated Rate |
$630.38 |
| Rate for Payer: Cash Price |
$284.54
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$280.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$252.15
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$252.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$266.16
|
| Rate for Payer: Fidelis Medicare Advantage |
$280.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$266.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$280.17
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$280.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$210.13
|
| Rate for Payer: Healthfirst Commercial |
$280.17
|
| Rate for Payer: Healthfirst Essential Plan |
$630.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$266.16
|
| Rate for Payer: Healthfirst QHP |
$280.17
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$196.12
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$280.17
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$238.14
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$196.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$280.17
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$210.13
|
| Rate for Payer: SOMOS Essential |
$210.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$280.17
|
|
|
PR PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS
|
Professional
|
Both
|
$4,318.34
|
|
|
Service Code
|
HCPCS 60500
|
| Min. Negotiated Rate |
$803.66 |
| Max. Negotiated Rate |
$2,583.18 |
| Rate for Payer: Cash Price |
$1,157.79
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,148.08
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,033.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,033.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,090.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,148.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,090.68
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,148.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,148.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$861.06
|
| Rate for Payer: Healthfirst Commercial |
$1,148.08
|
| Rate for Payer: Healthfirst Essential Plan |
$2,583.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,090.68
|
| Rate for Payer: Healthfirst QHP |
$1,148.08
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$803.66
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,148.08
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$975.87
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$803.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,148.08
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$861.06
|
| Rate for Payer: SOMOS Essential |
$861.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,148.08
|
|
|
PR PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR
|
Professional
|
Both
|
$5,812.66
|
|
|
Service Code
|
HCPCS 60502
|
| Min. Negotiated Rate |
$1,082.89 |
| Max. Negotiated Rate |
$3,480.73 |
| Rate for Payer: Cash Price |
$1,559.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,546.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,392.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,392.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,469.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,546.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,469.64
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,546.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,546.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,160.24
|
| Rate for Payer: Healthfirst Commercial |
$1,546.99
|
| Rate for Payer: Healthfirst Essential Plan |
$3,480.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,469.64
|
| Rate for Payer: Healthfirst QHP |
$1,546.99
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,082.89
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,546.99
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,314.94
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,082.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,546.99
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,160.24
|
| Rate for Payer: SOMOS Essential |
$1,160.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,546.99
|
|
|
PR PARAVAGINAL DEFECT REPAIR LAPAROSCOPIC APPROACH
|
Professional
|
Both
|
$4,027.45
|
|
|
Service Code
|
HCPCS 57423
|
| Min. Negotiated Rate |
$749.43 |
| Max. Negotiated Rate |
$2,408.87 |
| Rate for Payer: Cash Price |
$1,086.67
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,070.61
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$963.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$963.55
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,017.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,070.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,017.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,070.61
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,070.61
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$802.96
|
| Rate for Payer: Healthfirst Commercial |
$1,070.61
|
| Rate for Payer: Healthfirst Essential Plan |
$2,408.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,017.08
|
| Rate for Payer: Healthfirst QHP |
$1,070.61
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$749.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,070.61
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$910.02
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$749.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,070.61
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$802.96
|
| Rate for Payer: SOMOS Essential |
$802.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,070.61
|
|
|
PR PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APPR
|
Professional
|
Both
|
$3,590.58
|
|
|
Service Code
|
HCPCS 57284
|
| Min. Negotiated Rate |
$679.66 |
| Max. Negotiated Rate |
$2,184.61 |
| Rate for Payer: Cash Price |
$972.32
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$970.94
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$873.85
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$873.85
|
| Rate for Payer: Fidelis Essential Plan QHP |
$922.39
|
| Rate for Payer: Fidelis Medicare Advantage |
$970.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$922.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$970.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$970.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$728.21
|
| Rate for Payer: Healthfirst Commercial |
$970.94
|
| Rate for Payer: Healthfirst Essential Plan |
$2,184.61
|
| Rate for Payer: Healthfirst Medicare Advantage |
$922.39
|
| Rate for Payer: Healthfirst QHP |
$970.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$679.66
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$970.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$825.30
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$679.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$970.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$728.21
|
| Rate for Payer: SOMOS Essential |
$728.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$970.94
|
|
|
PR PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH
|
Professional
|
Both
|
$2,999.64
|
|
|
Service Code
|
HCPCS 57285
|
| Min. Negotiated Rate |
$560.47 |
| Max. Negotiated Rate |
$1,801.51 |
| Rate for Payer: Cash Price |
$811.14
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$800.67
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$720.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$720.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$760.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$800.67
|
| Rate for Payer: Fidelis Qualified Health Plan |
$760.64
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$800.67
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$800.67
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$600.50
|
| Rate for Payer: Healthfirst Commercial |
$800.67
|
| Rate for Payer: Healthfirst Essential Plan |
$1,801.51
|
| Rate for Payer: Healthfirst Medicare Advantage |
$760.64
|
| Rate for Payer: Healthfirst QHP |
$800.67
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$560.47
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$800.67
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$680.57
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$560.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$800.67
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$600.50
|
| Rate for Payer: SOMOS Essential |
$600.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$800.67
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1
|
Professional
|
Both
|
$66.29
|
|
|
Service Code
|
HCPCS 11055
|
| Min. Negotiated Rate |
$11.91 |
| Max. Negotiated Rate |
$38.30 |
| Rate for Payer: Cash Price |
$17.23
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$17.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$15.32
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$15.32
|
| Rate for Payer: Fidelis Essential Plan QHP |
$16.17
|
| Rate for Payer: Fidelis Medicare Advantage |
$17.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$16.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$17.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.77
|
| Rate for Payer: Healthfirst Commercial |
$17.02
|
| Rate for Payer: Healthfirst Essential Plan |
$38.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$16.17
|
| Rate for Payer: Healthfirst QHP |
$17.02
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$11.91
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$17.02
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$14.47
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$11.91
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$12.77
|
| Rate for Payer: SOMOS Essential |
$12.77
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17.02
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4
|
Professional
|
Both
|
$89.39
|
|
|
Service Code
|
HCPCS 11056
|
| Min. Negotiated Rate |
$17.05 |
| Max. Negotiated Rate |
$54.79 |
| Rate for Payer: Cash Price |
$24.26
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$24.35
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21.91
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$21.91
|
| Rate for Payer: Fidelis Essential Plan QHP |
$23.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$24.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$24.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$24.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18.26
|
| Rate for Payer: Healthfirst Commercial |
$24.35
|
| Rate for Payer: Healthfirst Essential Plan |
$54.79
|
| Rate for Payer: Healthfirst Medicare Advantage |
$23.13
|
| Rate for Payer: Healthfirst QHP |
$24.35
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$17.05
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$24.35
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$20.70
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$17.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$24.35
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18.26
|
| Rate for Payer: SOMOS Essential |
$18.26
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$24.35
|
|
|
PR PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4
|
Professional
|
Both
|
$113.93
|
|
|
Service Code
|
HCPCS 11057
|
| Min. Negotiated Rate |
$21.48 |
| Max. Negotiated Rate |
$69.05 |
| Rate for Payer: Cash Price |
$31.69
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$30.69
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$27.62
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$27.62
|
| Rate for Payer: Fidelis Essential Plan QHP |
$29.16
|
| Rate for Payer: Fidelis Medicare Advantage |
$30.69
|
| Rate for Payer: Fidelis Qualified Health Plan |
$29.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.69
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.69
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23.02
|
| Rate for Payer: Healthfirst Commercial |
$30.69
|
| Rate for Payer: Healthfirst Essential Plan |
$69.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$29.16
|
| Rate for Payer: Healthfirst QHP |
$30.69
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$21.48
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$30.69
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$26.09
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$21.48
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$30.69
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23.02
|
| Rate for Payer: SOMOS Essential |
$23.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$30.69
|
|
|
PR PAROTID DUCT DIVERSION BILATERAL WILKE PX
|
Professional
|
Both
|
$2,146.13
|
|
|
Service Code
|
HCPCS 42507
|
| Min. Negotiated Rate |
$400.62 |
| Max. Negotiated Rate |
$1,287.70 |
| Rate for Payer: Cash Price |
$582.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$572.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$515.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$515.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$543.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$572.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$543.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$572.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$572.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$429.23
|
| Rate for Payer: Healthfirst Commercial |
$572.31
|
| Rate for Payer: Healthfirst Essential Plan |
$1,287.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$543.69
|
| Rate for Payer: Healthfirst QHP |
$572.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$400.62
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$572.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$486.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$400.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$572.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$429.23
|
| Rate for Payer: SOMOS Essential |
$429.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$572.31
|
|
|
PR PAROTID DUCT DVRJ BILATERAL WITH LIG BOTH DUCTS
|
Professional
|
Both
|
$2,632.11
|
|
|
Service Code
|
HCPCS 42510
|
| Min. Negotiated Rate |
$492.87 |
| Max. Negotiated Rate |
$1,584.22 |
| Rate for Payer: Cash Price |
$713.31
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$704.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$633.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$633.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$668.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$704.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$668.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$704.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$704.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$528.08
|
| Rate for Payer: Healthfirst Commercial |
$704.10
|
| Rate for Payer: Healthfirst Essential Plan |
$1,584.22
|
| Rate for Payer: Healthfirst Medicare Advantage |
$668.89
|
| Rate for Payer: Healthfirst QHP |
$704.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$492.87
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$704.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$598.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$492.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$704.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$528.08
|
| Rate for Payer: SOMOS Essential |
$528.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$704.10
|
|
|
PR PAROTID DUCT DVRJ BI W/EXC BOTH SUBMNDBLR GLANDS
|
Professional
|
Both
|
$3,538.40
|
|
|
Service Code
|
HCPCS 42509
|
| Min. Negotiated Rate |
$660.53 |
| Max. Negotiated Rate |
$2,123.14 |
| Rate for Payer: Cash Price |
$956.79
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$943.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$849.26
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$849.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$896.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$943.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$896.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$943.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$943.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$707.72
|
| Rate for Payer: Healthfirst Commercial |
$943.62
|
| Rate for Payer: Healthfirst Essential Plan |
$2,123.14
|
| Rate for Payer: Healthfirst Medicare Advantage |
$896.44
|
| Rate for Payer: Healthfirst QHP |
$943.62
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$660.53
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$943.62
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$802.08
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$660.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$943.62
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$707.72
|
| Rate for Payer: SOMOS Essential |
$707.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$943.62
|
|
|
PR PARTIAL EXCISION BONE CLAVICLE
|
Professional
|
Both
|
$2,939.86
|
|
|
Service Code
|
HCPCS 23180
|
| Min. Negotiated Rate |
$578.98 |
| Max. Negotiated Rate |
$1,861.02 |
| Rate for Payer: Cash Price |
$794.84
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$827.12
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$744.41
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$744.41
|
| Rate for Payer: Fidelis Essential Plan QHP |
$785.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$827.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$785.76
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$827.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$827.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$620.34
|
| Rate for Payer: Healthfirst Commercial |
$827.12
|
| Rate for Payer: Healthfirst Essential Plan |
$1,861.02
|
| Rate for Payer: Healthfirst Medicare Advantage |
$785.76
|
| Rate for Payer: Healthfirst QHP |
$827.12
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$578.98
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$827.12
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$703.05
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$578.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$827.12
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$620.34
|
| Rate for Payer: SOMOS Essential |
$620.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$827.12
|
|
|
PR PARTIAL EXCISION BONE FIBULA
|
Professional
|
Both
|
$2,836.44
|
|
|
Service Code
|
HCPCS 27641
|
| Min. Negotiated Rate |
$539.55 |
| Max. Negotiated Rate |
$1,734.26 |
| Rate for Payer: Cash Price |
$769.95
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$770.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$693.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$693.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$732.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$770.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$732.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$770.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$770.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$578.09
|
| Rate for Payer: Healthfirst Commercial |
$770.78
|
| Rate for Payer: Healthfirst Essential Plan |
$1,734.26
|
| Rate for Payer: Healthfirst Medicare Advantage |
$732.24
|
| Rate for Payer: Healthfirst QHP |
$770.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$539.55
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$770.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$655.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$539.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$770.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$578.09
|
| Rate for Payer: SOMOS Essential |
$578.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$770.78
|
|
|
PR PARTIAL EXCISION BONE HUMERUS
|
Professional
|
Both
|
$3,124.73
|
|
|
Service Code
|
HCPCS 24140
|
| Min. Negotiated Rate |
$588.88 |
| Max. Negotiated Rate |
$1,892.84 |
| Rate for Payer: Cash Price |
$842.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$841.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$757.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$757.13
|
| Rate for Payer: Fidelis Essential Plan QHP |
$799.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$841.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$799.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$841.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$841.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$630.95
|
| Rate for Payer: Healthfirst Commercial |
$841.26
|
| Rate for Payer: Healthfirst Essential Plan |
$1,892.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$799.20
|
| Rate for Payer: Healthfirst QHP |
$841.26
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$588.88
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$841.26
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$715.07
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$588.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$841.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$630.95
|
| Rate for Payer: SOMOS Essential |
$630.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$841.26
|
|
|
PR PARTIAL EXCISION BONE METACARPAL
|
Professional
|
Both
|
$2,216.83
|
|
|
Service Code
|
HCPCS 26230
|
| Min. Negotiated Rate |
$420.63 |
| Max. Negotiated Rate |
$1,352.03 |
| Rate for Payer: Cash Price |
$601.61
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$600.90
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$540.81
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$540.81
|
| Rate for Payer: Fidelis Essential Plan QHP |
$570.86
|
| Rate for Payer: Fidelis Medicare Advantage |
$600.90
|
| Rate for Payer: Fidelis Qualified Health Plan |
$570.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$600.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$600.90
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$450.68
|
| Rate for Payer: Healthfirst Commercial |
$600.90
|
| Rate for Payer: Healthfirst Essential Plan |
$1,352.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$570.86
|
| Rate for Payer: Healthfirst QHP |
$600.90
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$420.63
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$600.90
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$510.76
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$420.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$600.90
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$450.68
|
| Rate for Payer: SOMOS Essential |
$450.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$600.90
|
|
|
PR PARTIAL EXCISION BONE OLECRANON PROCESS
|
Professional
|
Both
|
$2,789.33
|
|
|
Service Code
|
HCPCS 24147
|
| Min. Negotiated Rate |
$527.51 |
| Max. Negotiated Rate |
$1,695.58 |
| Rate for Payer: Cash Price |
$755.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$753.59
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$678.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$678.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$715.91
|
| Rate for Payer: Fidelis Medicare Advantage |
$753.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$715.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$753.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$753.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$565.19
|
| Rate for Payer: Healthfirst Commercial |
$753.59
|
| Rate for Payer: Healthfirst Essential Plan |
$1,695.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$715.91
|
| Rate for Payer: Healthfirst QHP |
$753.59
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$527.51
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$753.59
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$640.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$527.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$753.59
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$565.19
|
| Rate for Payer: SOMOS Essential |
$565.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$753.59
|
|
|
PR PARTIAL EXCISION BONE PROXIMAL HUMERUS
|
Professional
|
Both
|
$3,285.49
|
|
|
Service Code
|
HCPCS 23184
|
| Min. Negotiated Rate |
$618.72 |
| Max. Negotiated Rate |
$1,988.73 |
| Rate for Payer: Cash Price |
$890.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$883.88
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$795.49
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$795.49
|
| Rate for Payer: Fidelis Essential Plan QHP |
$839.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$883.88
|
| Rate for Payer: Fidelis Qualified Health Plan |
$839.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$883.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$883.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$662.91
|
| Rate for Payer: Healthfirst Commercial |
$883.88
|
| Rate for Payer: Healthfirst Essential Plan |
$1,988.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$839.69
|
| Rate for Payer: Healthfirst QHP |
$883.88
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$618.72
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$883.88
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$751.30
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$618.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$883.88
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$662.91
|
| Rate for Payer: SOMOS Essential |
$662.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$883.88
|
|
|
PR PARTIAL EXCISION BONE RADIAL HEAD/NECK
|
Professional
|
Both
|
$2,645.44
|
|
|
Service Code
|
HCPCS 24145
|
| Min. Negotiated Rate |
$499.77 |
| Max. Negotiated Rate |
$1,606.41 |
| Rate for Payer: Cash Price |
$716.91
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$713.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$642.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$642.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$678.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$713.96
|
| Rate for Payer: Fidelis Qualified Health Plan |
$678.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$713.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$713.96
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$535.47
|
| Rate for Payer: Healthfirst Commercial |
$713.96
|
| Rate for Payer: Healthfirst Essential Plan |
$1,606.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$678.26
|
| Rate for Payer: Healthfirst QHP |
$713.96
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$499.77
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$713.96
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$606.87
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$499.77
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$713.96
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$535.47
|
| Rate for Payer: SOMOS Essential |
$535.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$713.96
|
|
