|
PR RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5 CM/>
|
Professional
|
Both
|
$8,005.03
|
|
|
Service Code
|
HCPCS 27059
|
| Min. Negotiated Rate |
$1,503.66 |
| Max. Negotiated Rate |
$4,833.20 |
| Rate for Payer: Cash Price |
$2,154.30
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,148.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,933.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,933.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,040.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,148.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,040.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,148.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,148.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,611.07
|
| Rate for Payer: Healthfirst Commercial |
$2,148.09
|
| Rate for Payer: Healthfirst Essential Plan |
$4,833.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,040.69
|
| Rate for Payer: Healthfirst QHP |
$2,148.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,503.66
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,148.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,825.88
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,503.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,148.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,611.07
|
| Rate for Payer: SOMOS Essential |
$1,611.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,148.09
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5 CM/>
|
Professional
|
Both
|
$5,923.37
|
|
|
Service Code
|
HCPCS 22905
|
| Min. Negotiated Rate |
$1,109.15 |
| Max. Negotiated Rate |
$3,565.12 |
| Rate for Payer: Cash Price |
$1,592.56
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,584.50
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,426.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,426.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,505.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,584.50
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,505.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,584.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,584.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,188.38
|
| Rate for Payer: Healthfirst Commercial |
$1,584.50
|
| Rate for Payer: Healthfirst Essential Plan |
$3,565.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,505.28
|
| Rate for Payer: Healthfirst QHP |
$1,584.50
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,109.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,584.50
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,346.83
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,109.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,584.50
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,188.38
|
| Rate for Payer: SOMOS Essential |
$1,188.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,584.50
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM
|
Professional
|
Both
|
$4,694.41
|
|
|
Service Code
|
HCPCS 22904
|
| Min. Negotiated Rate |
$866.72 |
| Max. Negotiated Rate |
$2,785.88 |
| Rate for Payer: Cash Price |
$1,254.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,238.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,114.35
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,114.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,176.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,238.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,176.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,238.17
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,238.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$928.63
|
| Rate for Payer: Healthfirst Commercial |
$1,238.17
|
| Rate for Payer: Healthfirst Essential Plan |
$2,785.88
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,176.26
|
| Rate for Payer: Healthfirst QHP |
$1,238.17
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$866.72
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,238.17
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,052.44
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$866.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,238.17
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$928.63
|
| Rate for Payer: SOMOS Essential |
$928.63
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,238.17
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM
|
Professional
|
Both
|
$4,560.01
|
|
|
Service Code
|
HCPCS 21935
|
| Min. Negotiated Rate |
$848.39 |
| Max. Negotiated Rate |
$2,726.98 |
| Rate for Payer: Cash Price |
$1,226.56
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,211.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,090.79
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,090.79
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,151.39
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,211.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,151.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,211.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,211.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$908.99
|
| Rate for Payer: Healthfirst Commercial |
$1,211.99
|
| Rate for Payer: Healthfirst Essential Plan |
$2,726.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,151.39
|
| Rate for Payer: Healthfirst QHP |
$1,211.99
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$848.39
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,211.99
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,030.19
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$848.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,211.99
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$908.99
|
| Rate for Payer: SOMOS Essential |
$908.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,211.99
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5CM/>
|
Professional
|
Both
|
$6,335.28
|
|
|
Service Code
|
HCPCS 21936
|
| Min. Negotiated Rate |
$1,176.75 |
| Max. Negotiated Rate |
$3,782.41 |
| Rate for Payer: Cash Price |
$1,696.17
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,681.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,512.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,512.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,597.02
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,681.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,597.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,681.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,681.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,260.80
|
| Rate for Payer: Healthfirst Commercial |
$1,681.07
|
| Rate for Payer: Healthfirst Essential Plan |
$3,782.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,597.02
|
| Rate for Payer: Healthfirst QHP |
$1,681.07
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,176.75
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,681.07
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,428.91
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,176.75
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,681.07
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,260.80
|
| Rate for Payer: SOMOS Essential |
$1,260.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,681.07
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE 3 CM/>
|
Professional
|
Both
|
$4,438.46
|
|
|
Service Code
|
HCPCS 28047
|
| Min. Negotiated Rate |
$846.44 |
| Max. Negotiated Rate |
$2,720.70 |
| Rate for Payer: Cash Price |
$1,208.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,209.20
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,088.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,088.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,148.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,209.20
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,148.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,209.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,209.20
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$906.90
|
| Rate for Payer: Healthfirst Commercial |
$1,209.20
|
| Rate for Payer: Healthfirst Essential Plan |
$2,720.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,148.74
|
| Rate for Payer: Healthfirst QHP |
$1,209.20
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$846.44
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,209.20
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,027.82
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$846.44
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,209.20
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$906.90
|
| Rate for Payer: SOMOS Essential |
$906.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,209.20
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM
|
Professional
|
Both
|
$2,991.77
|
|
|
Service Code
|
HCPCS 28046
|
| Min. Negotiated Rate |
$568.11 |
| Max. Negotiated Rate |
$1,826.06 |
| Rate for Payer: Cash Price |
$802.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$811.58
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$730.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$730.42
|
| Rate for Payer: Fidelis Essential Plan QHP |
$771.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$811.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$771.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$811.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$811.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$608.68
|
| Rate for Payer: Healthfirst Commercial |
$811.58
|
| Rate for Payer: Healthfirst Essential Plan |
$1,826.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$771.00
|
| Rate for Payer: Healthfirst QHP |
$811.58
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$568.11
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$811.58
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$689.84
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$568.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$811.58
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$608.68
|
| Rate for Payer: SOMOS Essential |
$608.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$811.58
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE 5 CM/>
|
Professional
|
Both
|
$5,633.25
|
|
|
Service Code
|
HCPCS 27616
|
| Min. Negotiated Rate |
$1,032.36 |
| Max. Negotiated Rate |
$3,318.30 |
| Rate for Payer: Cash Price |
$1,501.68
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,474.80
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,327.32
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,327.32
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,401.06
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,474.80
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,401.06
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,474.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,474.80
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,106.10
|
| Rate for Payer: Healthfirst Commercial |
$1,474.80
|
| Rate for Payer: Healthfirst Essential Plan |
$3,318.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,401.06
|
| Rate for Payer: Healthfirst QHP |
$1,474.80
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,032.36
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,474.80
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,253.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,032.36
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,474.80
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,106.10
|
| Rate for Payer: SOMOS Essential |
$1,106.10
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,474.80
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE <5CM
|
Professional
|
Both
|
$4,541.46
|
|
|
Service Code
|
HCPCS 27615
|
| Min. Negotiated Rate |
$839.12 |
| Max. Negotiated Rate |
$2,697.16 |
| Rate for Payer: Cash Price |
$1,209.21
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,198.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,078.87
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,078.87
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,138.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,198.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,138.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,198.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,198.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$899.05
|
| Rate for Payer: Healthfirst Commercial |
$1,198.74
|
| Rate for Payer: Healthfirst Essential Plan |
$2,697.16
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,138.80
|
| Rate for Payer: Healthfirst QHP |
$1,198.74
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$839.12
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,198.74
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,018.93
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$839.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,198.74
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$899.05
|
| Rate for Payer: SOMOS Essential |
$899.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,198.74
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE SHOULDER 5 CM/>
|
Professional
|
Both
|
$6,382.43
|
|
|
Service Code
|
HCPCS 23078
|
| Min. Negotiated Rate |
$1,197.84 |
| Max. Negotiated Rate |
$3,850.20 |
| Rate for Payer: Cash Price |
$1,712.61
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,711.20
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,540.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,540.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,625.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,711.20
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,625.64
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,711.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,711.20
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,283.40
|
| Rate for Payer: Healthfirst Commercial |
$1,711.20
|
| Rate for Payer: Healthfirst Essential Plan |
$3,850.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,625.64
|
| Rate for Payer: Healthfirst QHP |
$1,711.20
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,197.84
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,711.20
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,454.52
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,197.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,711.20
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,283.40
|
| Rate for Payer: SOMOS Essential |
$1,283.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,711.20
|
|
|
PR RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM
|
Professional
|
Both
|
$5,066.64
|
|
|
Service Code
|
HCPCS 23077
|
| Min. Negotiated Rate |
$943.24 |
| Max. Negotiated Rate |
$3,031.83 |
| Rate for Payer: Cash Price |
$1,358.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,347.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,212.73
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,212.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,280.11
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,347.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,280.11
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,347.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,347.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,010.61
|
| Rate for Payer: Healthfirst Commercial |
$1,347.48
|
| Rate for Payer: Healthfirst Essential Plan |
$3,031.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,280.11
|
| Rate for Payer: Healthfirst QHP |
$1,347.48
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$943.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,347.48
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,145.36
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$943.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,347.48
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,010.61
|
| Rate for Payer: SOMOS Essential |
$1,010.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,347.48
|
|
|
PR RAD RESECTION TUMOR SOFT TIS THIGH/KNEE 5 CM/>
|
Professional
|
Both
|
$6,953.91
|
|
|
Service Code
|
HCPCS 27364
|
| Min. Negotiated Rate |
$1,299.00 |
| Max. Negotiated Rate |
$4,175.37 |
| Rate for Payer: Cash Price |
$1,863.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,855.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,670.15
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,670.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,762.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,855.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,762.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,855.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,855.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,391.79
|
| Rate for Payer: Healthfirst Commercial |
$1,855.72
|
| Rate for Payer: Healthfirst Essential Plan |
$4,175.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,762.93
|
| Rate for Payer: Healthfirst QHP |
$1,855.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,299.00
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,855.72
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,577.36
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,299.00
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,855.72
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,391.79
|
| Rate for Payer: SOMOS Essential |
$1,391.79
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,855.72
|
|
|
PR RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM
|
Professional
|
Both
|
$3,934.00
|
|
|
Service Code
|
HCPCS 25077
|
| Min. Negotiated Rate |
$723.70 |
| Max. Negotiated Rate |
$2,326.16 |
| Rate for Payer: Cash Price |
$1,040.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,033.85
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$930.47
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$930.47
|
| Rate for Payer: Fidelis Essential Plan QHP |
$982.16
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,033.85
|
| Rate for Payer: Fidelis Qualified Health Plan |
$982.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,033.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,033.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$775.39
|
| Rate for Payer: Healthfirst Commercial |
$1,033.85
|
| Rate for Payer: Healthfirst Essential Plan |
$2,326.16
|
| Rate for Payer: Healthfirst Medicare Advantage |
$982.16
|
| Rate for Payer: Healthfirst QHP |
$1,033.85
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$723.70
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,033.85
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$878.77
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$723.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,033.85
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$775.39
|
| Rate for Payer: SOMOS Essential |
$775.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,033.85
|
|
|
PR RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM
|
Professional
|
Both
|
$4,232.87
|
|
|
Service Code
|
HCPCS 21557
|
| Min. Negotiated Rate |
$788.17 |
| Max. Negotiated Rate |
$2,533.41 |
| Rate for Payer: Cash Price |
$1,143.38
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,125.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,013.36
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,013.36
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,069.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,125.96
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,069.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,125.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,125.96
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$844.47
|
| Rate for Payer: Healthfirst Commercial |
$1,125.96
|
| Rate for Payer: Healthfirst Essential Plan |
$2,533.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,069.66
|
| Rate for Payer: Healthfirst QHP |
$1,125.96
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$788.17
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,125.96
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$957.07
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$788.17
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,125.96
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$844.47
|
| Rate for Payer: SOMOS Essential |
$844.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,125.96
|
|
|
PR RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5CM/>
|
Professional
|
Both
|
$5,969.81
|
|
|
Service Code
|
HCPCS 21558
|
| Min. Negotiated Rate |
$1,106.52 |
| Max. Negotiated Rate |
$3,556.66 |
| Rate for Payer: Cash Price |
$1,594.18
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,580.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,422.67
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,422.67
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,501.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,580.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,501.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,580.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,580.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,185.56
|
| Rate for Payer: Healthfirst Commercial |
$1,580.74
|
| Rate for Payer: Healthfirst Essential Plan |
$3,556.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,501.70
|
| Rate for Payer: Healthfirst QHP |
$1,580.74
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,106.52
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,580.74
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,343.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,106.52
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,580.74
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,185.56
|
| Rate for Payer: SOMOS Essential |
$1,185.56
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,580.74
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM
|
Professional
|
Both
|
$3,274.60
|
|
|
Service Code
|
HCPCS 26117
|
| Min. Negotiated Rate |
$623.83 |
| Max. Negotiated Rate |
$2,005.18 |
| Rate for Payer: Cash Price |
$888.57
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$891.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$802.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$802.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$846.63
|
| Rate for Payer: Fidelis Medicare Advantage |
$891.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$846.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$891.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$891.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$668.39
|
| Rate for Payer: Healthfirst Commercial |
$891.19
|
| Rate for Payer: Healthfirst Essential Plan |
$2,005.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$846.63
|
| Rate for Payer: Healthfirst QHP |
$891.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$623.83
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$891.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$757.51
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$623.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$891.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$668.39
|
| Rate for Payer: SOMOS Essential |
$668.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$891.19
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM
|
Professional
|
Both
|
$5,985.46
|
|
|
Service Code
|
HCPCS 27049
|
| Min. Negotiated Rate |
$1,179.30 |
| Max. Negotiated Rate |
$3,790.60 |
| Rate for Payer: Cash Price |
$1,692.99
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,684.71
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,516.24
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,516.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,600.47
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,684.71
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,600.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,684.71
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,684.71
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,263.53
|
| Rate for Payer: Healthfirst Commercial |
$1,684.71
|
| Rate for Payer: Healthfirst Essential Plan |
$3,790.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,600.47
|
| Rate for Payer: Healthfirst QHP |
$1,684.71
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,179.30
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,684.71
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,432.00
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,179.30
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,684.71
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,263.53
|
| Rate for Payer: SOMOS Essential |
$1,263.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,684.71
|
|
|
PR RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM
|
Professional
|
Both
|
$4,639.18
|
|
|
Service Code
|
HCPCS 27329
|
| Min. Negotiated Rate |
$868.35 |
| Max. Negotiated Rate |
$2,791.12 |
| Rate for Payer: Cash Price |
$1,247.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,240.50
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,116.45
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,116.45
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,178.47
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,240.50
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,178.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,240.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,240.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$930.38
|
| Rate for Payer: Healthfirst Commercial |
$1,240.50
|
| Rate for Payer: Healthfirst Essential Plan |
$2,791.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,178.47
|
| Rate for Payer: Healthfirst QHP |
$1,240.50
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$868.35
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,240.50
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,054.42
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$868.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,240.50
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$930.38
|
| Rate for Payer: SOMOS Essential |
$930.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,240.50
|
|
|
PR RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW <5CM
|
Professional
|
Both
|
$4,604.95
|
|
|
Service Code
|
HCPCS 24077
|
| Min. Negotiated Rate |
$854.50 |
| Max. Negotiated Rate |
$2,746.62 |
| Rate for Payer: Cash Price |
$1,230.46
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,220.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,098.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,098.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,159.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,220.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,159.68
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,220.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,220.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$915.54
|
| Rate for Payer: Healthfirst Commercial |
$1,220.72
|
| Rate for Payer: Healthfirst Essential Plan |
$2,746.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,159.68
|
| Rate for Payer: Healthfirst QHP |
$1,220.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$854.50
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,220.72
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,037.61
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$854.50
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,220.72
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$915.54
|
| Rate for Payer: SOMOS Essential |
$915.54
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,220.72
|
|
|
PR RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW 5CM/>
|
Professional
|
Both
|
$5,911.29
|
|
|
Service Code
|
HCPCS 24079
|
| Min. Negotiated Rate |
$1,105.38 |
| Max. Negotiated Rate |
$3,553.00 |
| Rate for Payer: Cash Price |
$1,585.02
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,579.11
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,421.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,421.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,500.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,579.11
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,500.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,579.11
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,579.11
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,184.33
|
| Rate for Payer: Healthfirst Commercial |
$1,579.11
|
| Rate for Payer: Healthfirst Essential Plan |
$3,553.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,500.15
|
| Rate for Payer: Healthfirst QHP |
$1,579.11
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,105.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,579.11
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,342.24
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,105.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,579.11
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,184.33
|
| Rate for Payer: SOMOS Essential |
$1,184.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,579.11
|
|
|
PR RAD TRACHELECTOMY W/BI PEL LMPHADEC
|
Professional
|
Both
|
$8,501.78
|
|
|
Service Code
|
HCPCS 57531
|
| Min. Negotiated Rate |
$1,550.67 |
| Max. Negotiated Rate |
$4,984.29 |
| Rate for Payer: Cash Price |
$2,251.95
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,215.24
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,993.72
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,993.72
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,104.48
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,215.24
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,104.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,215.24
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,215.24
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,661.43
|
| Rate for Payer: Healthfirst Commercial |
$2,215.24
|
| Rate for Payer: Healthfirst Essential Plan |
$4,984.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,104.48
|
| Rate for Payer: Healthfirst QHP |
$2,215.24
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,550.67
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,215.24
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,882.95
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,550.67
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,215.24
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,661.43
|
| Rate for Payer: SOMOS Essential |
$1,661.43
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,215.24
|
|
|
PR RAPID DESENSITIZATION PROCEDURE EACH HOUR
|
Professional
|
Both
|
$405.90
|
|
|
Service Code
|
HCPCS 95180
|
| Min. Negotiated Rate |
$52.88 |
| Max. Negotiated Rate |
$250.25 |
| Rate for Payer: Amida Care Medicaid |
$52.88
|
| Rate for Payer: Cash Price |
$112.04
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$111.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$100.10
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$100.10
|
| Rate for Payer: Fidelis Essential Plan QHP |
$105.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$111.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$105.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$111.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$111.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$83.42
|
| Rate for Payer: Healthfirst Commercial |
$111.22
|
| Rate for Payer: Healthfirst Essential Plan |
$250.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$105.66
|
| Rate for Payer: Healthfirst QHP |
$111.22
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$77.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$111.22
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$94.54
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$77.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$111.22
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$83.42
|
| Rate for Payer: SOMOS Essential |
$83.42
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$111.22
|
|
|
PR RCM CELULR & SUBCELULR SKN IMGNG IMG ACQ EA ADDL
|
Professional
|
Both
|
$334.95
|
|
|
Service Code
|
HCPCS 96935
|
| Min. Negotiated Rate |
$61.95 |
| Max. Negotiated Rate |
$199.12 |
| Rate for Payer: Cash Price |
$91.16
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$88.50
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$79.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$79.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$84.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$88.50
|
| Rate for Payer: Fidelis Qualified Health Plan |
$84.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$88.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$88.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$66.38
|
| Rate for Payer: Healthfirst Commercial |
$88.50
|
| Rate for Payer: Healthfirst Essential Plan |
$199.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$84.08
|
| Rate for Payer: Healthfirst QHP |
$88.50
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$61.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$88.50
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$75.22
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$61.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$88.50
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$66.38
|
| Rate for Payer: SOMOS Essential |
$66.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$88.50
|
|
|
PR RCM CELULR & SUBCELULR SKN IMGNG IMG ACQ I&R 1ST
|
Professional
|
Both
|
$729.12
|
|
|
Service Code
|
HCPCS 96931
|
| Min. Negotiated Rate |
$134.06 |
| Max. Negotiated Rate |
$430.90 |
| Rate for Payer: Cash Price |
$197.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$191.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$172.36
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$172.36
|
| Rate for Payer: Fidelis Essential Plan QHP |
$181.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$191.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$181.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$191.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$191.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$143.63
|
| Rate for Payer: Healthfirst Commercial |
$191.51
|
| Rate for Payer: Healthfirst Essential Plan |
$430.90
|
| Rate for Payer: Healthfirst Medicare Advantage |
$181.93
|
| Rate for Payer: Healthfirst QHP |
$191.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$134.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$191.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$162.78
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$134.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$191.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$143.63
|
| Rate for Payer: SOMOS Essential |
$143.63
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$191.51
|
|
|
PR RCM CELULR & SUBCELULR SKN IMGNG IMG ACQ I&R ADD
|
Professional
|
Both
|
$502.88
|
|
|
Service Code
|
HCPCS 96934
|
| Min. Negotiated Rate |
$94.07 |
| Max. Negotiated Rate |
$302.38 |
| Rate for Payer: Cash Price |
$136.04
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$134.39
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$120.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$120.95
|
| Rate for Payer: Fidelis Essential Plan QHP |
$127.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$134.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$127.67
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$134.39
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$134.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$100.79
|
| Rate for Payer: Healthfirst Commercial |
$134.39
|
| Rate for Payer: Healthfirst Essential Plan |
$302.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$127.67
|
| Rate for Payer: Healthfirst QHP |
$134.39
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$94.07
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$134.39
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$114.23
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$94.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$134.39
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$100.79
|
| Rate for Payer: SOMOS Essential |
$100.79
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$134.39
|
|
