|
PR RADICAL RESECTION STERNUM W/MEDSTNL LMPHADEC
|
Professional
|
Both
|
$5,430.78
|
|
|
Service Code
|
HCPCS 21632
|
| Rate for Payer: Cash Price |
$1,451.08
|
|
|
PR RADICAL RESECTION TONSIL W/O CLOSURE
|
Professional
|
Both
|
$4,369.40
|
|
|
Service Code
|
HCPCS 42842
|
| Min. Negotiated Rate |
$814.88 |
| Max. Negotiated Rate |
$2,619.25 |
| Rate for Payer: Cash Price |
$1,180.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,164.11
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,047.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,047.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,105.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,164.11
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,105.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,164.11
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,164.11
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$873.08
|
| Rate for Payer: Healthfirst Commercial |
$1,164.11
|
| Rate for Payer: Healthfirst Essential Plan |
$2,619.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,105.90
|
| Rate for Payer: Healthfirst QHP |
$1,164.11
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$814.88
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,164.11
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$989.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$814.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,164.11
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$873.08
|
| Rate for Payer: SOMOS Essential |
$873.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,164.11
|
|
|
PR RADICAL RESECTION TUMOR BONE FIBULA
|
Professional
|
Both
|
$6,765.12
|
|
|
Service Code
|
HCPCS 27646
|
| Min. Negotiated Rate |
$1,269.25 |
| Max. Negotiated Rate |
$4,079.72 |
| Rate for Payer: Cash Price |
$1,820.88
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,813.21
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,631.89
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,631.89
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,722.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,813.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,722.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,813.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,813.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,359.91
|
| Rate for Payer: Healthfirst Commercial |
$1,813.21
|
| Rate for Payer: Healthfirst Essential Plan |
$4,079.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,722.55
|
| Rate for Payer: Healthfirst QHP |
$1,813.21
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,269.25
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,813.21
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,541.23
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,269.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,813.21
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,359.91
|
| Rate for Payer: SOMOS Essential |
$1,359.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,813.21
|
|
|
PR RADICAL RESECTION TUMOR CLAVICLE
|
Professional
|
Both
|
$6,637.75
|
|
|
Service Code
|
HCPCS 23200
|
| Min. Negotiated Rate |
$1,244.94 |
| Max. Negotiated Rate |
$4,001.58 |
| Rate for Payer: Cash Price |
$1,786.34
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,778.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,600.63
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,600.63
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,689.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,778.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,689.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,778.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,778.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,333.86
|
| Rate for Payer: Healthfirst Commercial |
$1,778.48
|
| Rate for Payer: Healthfirst Essential Plan |
$4,001.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,689.56
|
| Rate for Payer: Healthfirst QHP |
$1,778.48
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,244.94
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,778.48
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,511.71
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,244.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,778.48
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,333.86
|
| Rate for Payer: SOMOS Essential |
$1,333.86
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,778.48
|
|
|
PR RADICAL RESECTION TUMOR DISTAL PHALANX FINGER
|
Professional
|
Both
|
$2,800.49
|
|
|
Service Code
|
HCPCS 26262
|
| Min. Negotiated Rate |
$530.50 |
| Max. Negotiated Rate |
$1,705.18 |
| Rate for Payer: Cash Price |
$759.56
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$757.86
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$682.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$682.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$719.97
|
| Rate for Payer: Fidelis Medicare Advantage |
$757.86
|
| Rate for Payer: Fidelis Qualified Health Plan |
$719.97
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$757.86
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$757.86
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$568.39
|
| Rate for Payer: Healthfirst Commercial |
$757.86
|
| Rate for Payer: Healthfirst Essential Plan |
$1,705.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$719.97
|
| Rate for Payer: Healthfirst QHP |
$757.86
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$530.50
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$757.86
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$644.18
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$530.50
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$757.86
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$568.39
|
| Rate for Payer: SOMOS Essential |
$568.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$757.86
|
|
|
PR RADICAL RESECTION TUMOR FEMOR OR KNEE
|
Professional
|
Both
|
$9,038.51
|
|
|
Service Code
|
HCPCS 27365
|
| Min. Negotiated Rate |
$1,693.27 |
| Max. Negotiated Rate |
$5,442.64 |
| Rate for Payer: Cash Price |
$2,429.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,418.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,177.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,177.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,298.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,418.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,298.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,418.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,418.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,814.21
|
| Rate for Payer: Healthfirst Commercial |
$2,418.95
|
| Rate for Payer: Healthfirst Essential Plan |
$5,442.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,298.00
|
| Rate for Payer: Healthfirst QHP |
$2,418.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,693.27
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,418.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,056.11
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,693.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,418.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,814.21
|
| Rate for Payer: SOMOS Essential |
$1,814.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,418.95
|
|
|
PR RADICAL RESECTION TUMOR METACARPAL
|
Professional
|
Both
|
$4,708.80
|
|
|
Service Code
|
HCPCS 26250
|
| Min. Negotiated Rate |
$886.63 |
| Max. Negotiated Rate |
$2,849.89 |
| Rate for Payer: Cash Price |
$1,272.51
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,266.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,139.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,139.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,203.29
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,266.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,203.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,266.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,266.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$949.97
|
| Rate for Payer: Healthfirst Commercial |
$1,266.62
|
| Rate for Payer: Healthfirst Essential Plan |
$2,849.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,203.29
|
| Rate for Payer: Healthfirst QHP |
$1,266.62
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$886.63
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,266.62
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,076.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$886.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,266.62
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$949.97
|
| Rate for Payer: SOMOS Essential |
$949.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,266.62
|
|
|
PR RADICAL RESECTION TUMOR METATARSAL
|
Professional
|
Both
|
$2,969.89
|
|
|
Service Code
|
HCPCS 28173
|
| Min. Negotiated Rate |
$569.25 |
| Max. Negotiated Rate |
$1,829.72 |
| Rate for Payer: Cash Price |
$818.57
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$813.21
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$731.89
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$731.89
|
| Rate for Payer: Fidelis Essential Plan QHP |
$772.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$813.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$772.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$813.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$813.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$609.91
|
| Rate for Payer: Healthfirst Commercial |
$813.21
|
| Rate for Payer: Healthfirst Essential Plan |
$1,829.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$772.55
|
| Rate for Payer: Healthfirst QHP |
$813.21
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$569.25
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$813.21
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$691.23
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$569.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$813.21
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$609.91
|
| Rate for Payer: SOMOS Essential |
$609.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$813.21
|
|
|
PR RADICAL RESECTION TUMOR PHALANX OR TOE
|
Professional
|
Both
|
$1,932.04
|
|
|
Service Code
|
HCPCS 28175
|
| Min. Negotiated Rate |
$371.88 |
| Max. Negotiated Rate |
$1,195.34 |
| Rate for Payer: Cash Price |
$534.32
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$531.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$478.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$478.13
|
| Rate for Payer: Fidelis Essential Plan QHP |
$504.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$531.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$504.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$531.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$531.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$398.44
|
| Rate for Payer: Healthfirst Commercial |
$531.26
|
| Rate for Payer: Healthfirst Essential Plan |
$1,195.34
|
| Rate for Payer: Healthfirst Medicare Advantage |
$504.70
|
| Rate for Payer: Healthfirst QHP |
$531.26
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$371.88
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$531.26
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$451.57
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$371.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$531.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$398.44
|
| Rate for Payer: SOMOS Essential |
$398.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$531.26
|
|
|
PR RADICAL RESECTION TUMOR RADIAL HEAD/NECK
|
Professional
|
Both
|
$5,925.22
|
|
|
Service Code
|
HCPCS 24152
|
| Min. Negotiated Rate |
$1,113.05 |
| Max. Negotiated Rate |
$3,577.66 |
| Rate for Payer: Cash Price |
$1,597.58
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,590.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,431.06
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,431.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,510.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,590.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,510.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,590.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,590.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,192.55
|
| Rate for Payer: Healthfirst Commercial |
$1,590.07
|
| Rate for Payer: Healthfirst Essential Plan |
$3,577.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,510.57
|
| Rate for Payer: Healthfirst QHP |
$1,590.07
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,113.05
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,590.07
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,351.56
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,113.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,590.07
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,192.55
|
| Rate for Payer: SOMOS Essential |
$1,192.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,590.07
|
|
|
PR RADICAL RESECTION TUMOR RADIUS OR ULNA
|
Professional
|
Both
|
$6,474.44
|
|
|
Service Code
|
HCPCS 25170
|
| Min. Negotiated Rate |
$1,213.88 |
| Max. Negotiated Rate |
$3,901.75 |
| Rate for Payer: Cash Price |
$1,742.84
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,734.11
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,560.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,560.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,647.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,734.11
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,647.40
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,734.11
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,734.11
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,300.58
|
| Rate for Payer: Healthfirst Commercial |
$1,734.11
|
| Rate for Payer: Healthfirst Essential Plan |
$3,901.75
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,647.40
|
| Rate for Payer: Healthfirst QHP |
$1,734.11
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,213.88
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,734.11
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,473.99
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,213.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,734.11
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,300.58
|
| Rate for Payer: SOMOS Essential |
$1,300.58
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,734.11
|
|
|
PR RADICAL RESECTION TUMOR SCAPULA
|
Professional
|
Both
|
$7,788.03
|
|
|
Service Code
|
HCPCS 23210
|
| Min. Negotiated Rate |
$1,459.22 |
| Max. Negotiated Rate |
$4,690.35 |
| Rate for Payer: Cash Price |
$2,094.27
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,084.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,876.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,876.14
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,980.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,084.60
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,980.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,084.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,084.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,563.45
|
| Rate for Payer: Healthfirst Commercial |
$2,084.60
|
| Rate for Payer: Healthfirst Essential Plan |
$4,690.35
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,980.37
|
| Rate for Payer: Healthfirst QHP |
$2,084.60
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,459.22
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,084.60
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,771.91
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,459.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,084.60
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,563.45
|
| Rate for Payer: SOMOS Essential |
$1,563.45
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,084.60
|
|
|
PR RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS
|
Professional
|
Both
|
$6,807.36
|
|
|
Service Code
|
HCPCS 24150
|
| Min. Negotiated Rate |
$1,276.74 |
| Max. Negotiated Rate |
$4,103.80 |
| Rate for Payer: Cash Price |
$1,833.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,823.91
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,641.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,641.52
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,732.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,823.91
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,732.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,823.91
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,823.91
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,367.93
|
| Rate for Payer: Healthfirst Commercial |
$1,823.91
|
| Rate for Payer: Healthfirst Essential Plan |
$4,103.80
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,732.71
|
| Rate for Payer: Healthfirst QHP |
$1,823.91
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,276.74
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,823.91
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,550.32
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,276.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,823.91
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,367.93
|
| Rate for Payer: SOMOS Essential |
$1,367.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,823.91
|
|
|
PR RADICAL STYLOIDECTOMY SEPARATE PROCEDURE
|
Professional
|
Both
|
$1,918.21
|
|
|
Service Code
|
HCPCS 25230
|
| Min. Negotiated Rate |
$366.00 |
| Max. Negotiated Rate |
$1,176.43 |
| Rate for Payer: Cash Price |
$523.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$522.86
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$470.57
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$470.57
|
| Rate for Payer: Fidelis Essential Plan QHP |
$496.72
|
| Rate for Payer: Fidelis Medicare Advantage |
$522.86
|
| Rate for Payer: Fidelis Qualified Health Plan |
$496.72
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$522.86
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$522.86
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$392.14
|
| Rate for Payer: Healthfirst Commercial |
$522.86
|
| Rate for Payer: Healthfirst Essential Plan |
$1,176.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$496.72
|
| Rate for Payer: Healthfirst QHP |
$522.86
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$366.00
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$522.86
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$444.43
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$366.00
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$522.86
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$392.14
|
| Rate for Payer: SOMOS Essential |
$392.14
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$522.86
|
|
|
PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN
|
Professional
|
Both
|
$802.80
|
|
|
Service Code
|
HCPCS 64625
|
| Min. Negotiated Rate |
$155.26 |
| Max. Negotiated Rate |
$499.05 |
| Rate for Payer: Cash Price |
$221.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$221.80
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$199.62
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$199.62
|
| Rate for Payer: Fidelis Essential Plan QHP |
$210.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$221.80
|
| Rate for Payer: Fidelis Qualified Health Plan |
$210.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$221.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$221.80
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$166.35
|
| Rate for Payer: Healthfirst Commercial |
$221.80
|
| Rate for Payer: Healthfirst Essential Plan |
$499.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$210.71
|
| Rate for Payer: Healthfirst QHP |
$221.80
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$155.26
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$221.80
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$188.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$155.26
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$221.80
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$166.35
|
| Rate for Payer: SOMOS Essential |
$166.35
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$221.80
|
|
|
PR RAD RESCJ CAPSL TISS&HTRTPC BONE ELBW CONTRCT
|
Professional
|
Both
|
$5,199.85
|
|
|
Service Code
|
HCPCS 24149
|
| Min. Negotiated Rate |
$981.03 |
| Max. Negotiated Rate |
$3,153.31 |
| Rate for Payer: Cash Price |
$1,408.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,401.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,261.32
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,261.32
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,331.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,401.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,331.40
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,401.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,401.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,051.10
|
| Rate for Payer: Healthfirst Commercial |
$1,401.47
|
| Rate for Payer: Healthfirst Essential Plan |
$3,153.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,331.40
|
| Rate for Payer: Healthfirst QHP |
$1,401.47
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$981.03
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,401.47
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,191.25
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$981.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,401.47
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,051.10
|
| Rate for Payer: SOMOS Essential |
$1,051.10
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,401.47
|
|
|
PR RAD RESCJ TUMOR TARSAL EXCEPT TALUS/CALCANEUS
|
Professional
|
Both
|
$4,887.37
|
|
|
Service Code
|
HCPCS 28171
|
| Min. Negotiated Rate |
$918.08 |
| Max. Negotiated Rate |
$2,950.97 |
| Rate for Payer: Cash Price |
$1,317.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,311.54
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,180.39
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,180.39
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,245.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,311.54
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,245.96
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,311.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,311.54
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$983.65
|
| Rate for Payer: Healthfirst Commercial |
$1,311.54
|
| Rate for Payer: Healthfirst Essential Plan |
$2,950.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,245.96
|
| Rate for Payer: Healthfirst QHP |
$1,311.54
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$918.08
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,311.54
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,114.81
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$918.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,311.54
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$983.65
|
| Rate for Payer: SOMOS Essential |
$983.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,311.54
|
|
|
PR RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3 CM/>
|
Professional
|
Both
|
$5,196.49
|
|
|
Service Code
|
HCPCS 25078
|
| Min. Negotiated Rate |
$971.82 |
| Max. Negotiated Rate |
$3,123.70 |
| Rate for Payer: Cash Price |
$1,395.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,388.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,249.48
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,249.48
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,318.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,388.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,318.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,388.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,388.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,041.23
|
| Rate for Payer: Healthfirst Commercial |
$1,388.31
|
| Rate for Payer: Healthfirst Essential Plan |
$3,123.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,318.89
|
| Rate for Payer: Healthfirst QHP |
$1,388.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$971.82
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,388.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,180.06
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$971.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,388.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,041.23
|
| Rate for Payer: SOMOS Essential |
$1,041.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,388.31
|
|
|
PR RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>
|
Professional
|
Both
|
$4,653.85
|
|
|
Service Code
|
HCPCS 26118
|
| Min. Negotiated Rate |
$876.43 |
| Max. Negotiated Rate |
$2,817.09 |
| Rate for Payer: Cash Price |
$1,249.19
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,252.04
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,126.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,126.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,189.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,252.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,189.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,252.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,252.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$939.03
|
| Rate for Payer: Healthfirst Commercial |
$1,252.04
|
| Rate for Payer: Healthfirst Essential Plan |
$2,817.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,189.44
|
| Rate for Payer: Healthfirst QHP |
$1,252.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$876.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,252.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,064.23
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$876.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,252.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$939.03
|
| Rate for Payer: SOMOS Essential |
$939.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,252.04
|
|
|
PR RAD RESCT TUMOR ILIUM ACETABULUM BOTH PUBIC
|
Professional
|
Both
|
$11,082.02
|
|
|
Service Code
|
HCPCS 27076
|
| Min. Negotiated Rate |
$2,069.64 |
| Max. Negotiated Rate |
$6,652.42 |
| Rate for Payer: Cash Price |
$2,974.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,956.63
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,660.97
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,660.97
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,808.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,956.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,808.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,956.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,956.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,217.47
|
| Rate for Payer: Healthfirst Commercial |
$2,956.63
|
| Rate for Payer: Healthfirst Essential Plan |
$6,652.42
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,808.80
|
| Rate for Payer: Healthfirst QHP |
$2,956.63
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,069.64
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,956.63
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,513.14
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,069.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,956.63
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,217.47
|
| Rate for Payer: SOMOS Essential |
$2,217.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,956.63
|
|
|
PR RAD RESCT TUMOR ISCHIAL TUBEROSITY&GRT TRCHNTR
|
Professional
|
Both
|
$9,037.46
|
|
|
Service Code
|
HCPCS 27078
|
| Min. Negotiated Rate |
$1,692.13 |
| Max. Negotiated Rate |
$5,438.99 |
| Rate for Payer: Cash Price |
$2,429.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,417.33
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,175.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,175.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,296.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,417.33
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,296.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,417.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,417.33
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,813.00
|
| Rate for Payer: Healthfirst Commercial |
$2,417.33
|
| Rate for Payer: Healthfirst Essential Plan |
$5,438.99
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,296.46
|
| Rate for Payer: Healthfirst QHP |
$2,417.33
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,692.13
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,417.33
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,054.73
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,692.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,417.33
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,813.00
|
| Rate for Payer: SOMOS Essential |
$1,813.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,417.33
|
|
|
PR RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL
|
Professional
|
Both
|
$9,167.59
|
|
|
Service Code
|
HCPCS 27075
|
| Min. Negotiated Rate |
$1,715.41 |
| Max. Negotiated Rate |
$5,513.83 |
| Rate for Payer: Cash Price |
$2,463.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,450.59
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,205.53
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,205.53
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,328.06
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,450.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,328.06
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,450.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,450.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,837.94
|
| Rate for Payer: Healthfirst Commercial |
$2,450.59
|
| Rate for Payer: Healthfirst Essential Plan |
$5,513.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,328.06
|
| Rate for Payer: Healthfirst QHP |
$2,450.59
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,715.41
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,450.59
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,083.00
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,715.41
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,450.59
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,837.94
|
| Rate for Payer: SOMOS Essential |
$1,837.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,450.59
|
|
|
PR RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER
|
Professional
|
Both
|
$3,534.13
|
|
|
Service Code
|
HCPCS 26260
|
| Min. Negotiated Rate |
$665.84 |
| Max. Negotiated Rate |
$2,140.20 |
| Rate for Payer: Cash Price |
$954.09
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$951.20
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$856.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$856.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$903.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$951.20
|
| Rate for Payer: Fidelis Qualified Health Plan |
$903.64
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$951.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$951.20
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$713.40
|
| Rate for Payer: Healthfirst Commercial |
$951.20
|
| Rate for Payer: Healthfirst Essential Plan |
$2,140.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$903.64
|
| Rate for Payer: Healthfirst QHP |
$951.20
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$665.84
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$951.20
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$808.52
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$665.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$951.20
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$713.40
|
| Rate for Payer: SOMOS Essential |
$713.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$951.20
|
|
|
PR RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2 CM/>
|
Professional
|
Both
|
$4,423.55
|
|
|
Service Code
|
HCPCS 21016
|
| Min. Negotiated Rate |
$825.51 |
| Max. Negotiated Rate |
$2,653.43 |
| Rate for Payer: Cash Price |
$1,190.41
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,179.30
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,061.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,061.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,120.34
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,179.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,120.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,179.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,179.30
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$884.48
|
| Rate for Payer: Healthfirst Commercial |
$1,179.30
|
| Rate for Payer: Healthfirst Essential Plan |
$2,653.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,120.34
|
| Rate for Payer: Healthfirst QHP |
$1,179.30
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$825.51
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,179.30
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,002.40
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$825.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,179.30
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$884.48
|
| Rate for Payer: SOMOS Essential |
$884.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,179.30
|
|
|
PR RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM
|
Professional
|
Both
|
$3,044.02
|
|
|
Service Code
|
HCPCS 21015
|
| Min. Negotiated Rate |
$575.23 |
| Max. Negotiated Rate |
$1,848.94 |
| Rate for Payer: Cash Price |
$821.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$821.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$739.58
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$739.58
|
| Rate for Payer: Fidelis Essential Plan QHP |
$780.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$821.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$780.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$821.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$821.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$616.31
|
| Rate for Payer: Healthfirst Commercial |
$821.75
|
| Rate for Payer: Healthfirst Essential Plan |
$1,848.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$780.66
|
| Rate for Payer: Healthfirst QHP |
$821.75
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$575.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$821.75
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$698.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$575.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$821.75
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$616.31
|
| Rate for Payer: SOMOS Essential |
$616.31
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$821.75
|
|
