|
PR RHINOPLASTY SECONDARY MAJOR REVISION
|
Professional
|
Both
|
$7,698.78
|
|
|
Service Code
|
HCPCS 30450
|
| Min. Negotiated Rate |
$1,425.70 |
| Max. Negotiated Rate |
$4,582.60 |
| Rate for Payer: Cash Price |
$2,065.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,036.71
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,833.04
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,833.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,934.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,036.71
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,934.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,036.71
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,036.71
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,527.53
|
| Rate for Payer: Healthfirst Commercial |
$2,036.71
|
| Rate for Payer: Healthfirst Essential Plan |
$4,582.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,934.87
|
| Rate for Payer: Healthfirst QHP |
$2,036.71
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,425.70
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,036.71
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,731.20
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,425.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,036.71
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,527.53
|
| Rate for Payer: SOMOS Essential |
$1,527.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,036.71
|
|
|
PR RHINOPLASTY SECONDARY MINOR REVISION
|
Professional
|
Both
|
$4,735.78
|
|
|
Service Code
|
HCPCS 30430
|
| Min. Negotiated Rate |
$872.67 |
| Max. Negotiated Rate |
$2,805.01 |
| Rate for Payer: Cash Price |
$1,272.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,246.67
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,122.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,122.00
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,184.34
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,246.67
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,184.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,246.67
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,246.67
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$935.00
|
| Rate for Payer: Healthfirst Commercial |
$1,246.67
|
| Rate for Payer: Healthfirst Essential Plan |
$2,805.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,184.34
|
| Rate for Payer: Healthfirst QHP |
$1,246.67
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$872.67
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,246.67
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,059.67
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$872.67
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,246.67
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$935.00
|
| Rate for Payer: SOMOS Essential |
$935.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,246.67
|
|
|
PR RHINP DFRM COLUM LNGTH TIP SEPTUM OSTEOT
|
Professional
|
Both
|
$7,008.86
|
|
|
Service Code
|
HCPCS 30462
|
| Min. Negotiated Rate |
$1,301.29 |
| Max. Negotiated Rate |
$4,182.73 |
| Rate for Payer: Cash Price |
$1,880.19
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,858.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,673.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,673.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,766.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,858.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,766.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,858.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,858.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,394.24
|
| Rate for Payer: Healthfirst Commercial |
$1,858.99
|
| Rate for Payer: Healthfirst Essential Plan |
$4,182.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,766.04
|
| Rate for Payer: Healthfirst QHP |
$1,858.99
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,301.29
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,858.99
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,580.14
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,301.29
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,858.99
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,394.24
|
| Rate for Payer: SOMOS Essential |
$1,394.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,858.99
|
|
|
PR RHINP DFRM W/COLUM LNGTH TIP ONLY
|
Professional
|
Both
|
$3,648.54
|
|
|
Service Code
|
HCPCS 30460
|
| Min. Negotiated Rate |
$678.59 |
| Max. Negotiated Rate |
$2,181.17 |
| Rate for Payer: Cash Price |
$978.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$969.41
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$872.47
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$872.47
|
| Rate for Payer: Fidelis Essential Plan QHP |
$920.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$969.41
|
| Rate for Payer: Fidelis Qualified Health Plan |
$920.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$969.41
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$969.41
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$727.06
|
| Rate for Payer: Healthfirst Commercial |
$969.41
|
| Rate for Payer: Healthfirst Essential Plan |
$2,181.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$920.94
|
| Rate for Payer: Healthfirst QHP |
$969.41
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$678.59
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$969.41
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$824.00
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$678.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$969.41
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$727.06
|
| Rate for Payer: SOMOS Essential |
$727.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$969.41
|
|
|
PR RHINP PRIM COMPLETE XTRNL PARTS
|
Professional
|
Both
|
$6,223.74
|
|
|
Service Code
|
HCPCS 30410
|
| Min. Negotiated Rate |
$1,151.29 |
| Max. Negotiated Rate |
$3,700.57 |
| Rate for Payer: Cash Price |
$1,672.30
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,644.70
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,480.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,480.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,562.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,644.70
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,562.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,644.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,644.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,233.53
|
| Rate for Payer: Healthfirst Commercial |
$1,644.70
|
| Rate for Payer: Healthfirst Essential Plan |
$3,700.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,562.46
|
| Rate for Payer: Healthfirst QHP |
$1,644.70
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,151.29
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,644.70
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,397.99
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,151.29
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,644.70
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,233.53
|
| Rate for Payer: SOMOS Essential |
$1,233.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,644.70
|
|
|
PR RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI
|
Professional
|
Both
|
$5,412.61
|
|
|
Service Code
|
HCPCS 30400
|
| Min. Negotiated Rate |
$999.12 |
| Max. Negotiated Rate |
$3,211.45 |
| Rate for Payer: Cash Price |
$1,454.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,427.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,284.58
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,284.58
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,355.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,427.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,355.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,427.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,427.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,070.48
|
| Rate for Payer: Healthfirst Commercial |
$1,427.31
|
| Rate for Payer: Healthfirst Essential Plan |
$3,211.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,355.94
|
| Rate for Payer: Healthfirst QHP |
$1,427.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$999.12
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,427.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,213.21
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$999.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,427.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,070.48
|
| Rate for Payer: SOMOS Essential |
$1,070.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,427.31
|
|
|
PR R HRT CATH CHD W/IMG CATH TRGT ZON ABNL NT CONNJ
|
Professional
|
Both
|
$1,140.13
|
|
|
Service Code
|
HCPCS 93594 26
|
| Min. Negotiated Rate |
$216.12 |
| Max. Negotiated Rate |
$694.66 |
| Rate for Payer: Cash Price |
$307.04
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$308.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$277.87
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$277.87
|
| Rate for Payer: Fidelis Essential Plan QHP |
$293.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$308.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$293.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$308.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$308.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$231.56
|
| Rate for Payer: Healthfirst Commercial |
$308.74
|
| Rate for Payer: Healthfirst Essential Plan |
$694.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$293.30
|
| Rate for Payer: Healthfirst QHP |
$308.74
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$216.12
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$308.74
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$262.43
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$216.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$308.74
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$231.56
|
| Rate for Payer: SOMOS Essential |
$231.56
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$308.74
|
|
|
PR R HRT CATH CHD W/IMG CATH TRGT ZONE NML NT CONNJ
|
Professional
|
Both
|
$737.87
|
|
|
Service Code
|
HCPCS 93593 26
|
| Min. Negotiated Rate |
$140.91 |
| Max. Negotiated Rate |
$452.93 |
| Rate for Payer: Cash Price |
$202.13
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$201.30
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$181.17
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$181.17
|
| Rate for Payer: Fidelis Essential Plan QHP |
$191.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$201.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$191.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$201.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$201.30
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$150.97
|
| Rate for Payer: Healthfirst Commercial |
$201.30
|
| Rate for Payer: Healthfirst Essential Plan |
$452.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$191.24
|
| Rate for Payer: Healthfirst QHP |
$201.30
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$140.91
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$201.30
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$171.10
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$140.91
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$201.30
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$150.97
|
| Rate for Payer: SOMOS Essential |
$150.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$201.30
|
|
|
PR RHYTHM ECG 1-3 LEADS INTERPRETATION & REPRT ON
|
Professional
|
Both
|
$27.27
|
|
|
Service Code
|
HCPCS 93042
|
| Min. Negotiated Rate |
$5.14 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Cash Price |
$7.43
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$7.34
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$6.61
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$6.61
|
| Rate for Payer: Fidelis Essential Plan QHP |
$6.97
|
| Rate for Payer: Fidelis Medicare Advantage |
$7.34
|
| Rate for Payer: Fidelis Qualified Health Plan |
$6.97
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7.34
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$7.34
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.50
|
| Rate for Payer: Healthfirst Commercial |
$7.34
|
| Rate for Payer: Healthfirst Essential Plan |
$16.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$6.97
|
| Rate for Payer: Healthfirst QHP |
$7.34
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$5.14
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$7.34
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$6.24
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$5.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$7.34
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$5.50
|
| Rate for Payer: SOMOS Essential |
$5.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7.34
|
|
|
PR RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R
|
Professional
|
Both
|
$27.16
|
|
|
Service Code
|
HCPCS 93041
|
| Min. Negotiated Rate |
$5.59 |
| Max. Negotiated Rate |
$17.98 |
| Rate for Payer: Cash Price |
$7.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$7.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.19
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7.19
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.59
|
| Rate for Payer: Fidelis Medicare Advantage |
$7.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$7.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$7.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$5.99
|
| Rate for Payer: Healthfirst Commercial |
$7.99
|
| Rate for Payer: Healthfirst Essential Plan |
$17.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7.59
|
| Rate for Payer: Healthfirst QHP |
$7.99
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$5.59
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$7.99
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$6.79
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$5.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$7.99
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$5.99
|
| Rate for Payer: SOMOS Essential |
$5.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$7.99
|
|
|
PR RHYTHM ECG 1-3 LEADS W/INTERPRETATION & REPORT
|
Professional
|
Both
|
$54.46
|
|
|
Service Code
|
HCPCS 93040
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$34.49 |
| Rate for Payer: Amida Care Medicaid |
$7.25
|
| Rate for Payer: Cash Price |
$15.13
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$15.33
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$13.80
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$13.80
|
| Rate for Payer: Fidelis Essential Plan QHP |
$14.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$15.33
|
| Rate for Payer: Fidelis Qualified Health Plan |
$14.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.33
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$11.50
|
| Rate for Payer: Healthfirst Commercial |
$15.33
|
| Rate for Payer: Healthfirst Essential Plan |
$34.49
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14.56
|
| Rate for Payer: Healthfirst QHP |
$15.33
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$10.73
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$15.33
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$13.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$10.73
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15.33
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$11.50
|
| Rate for Payer: SOMOS Essential |
$11.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15.33
|
|
|
PR RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT
|
Professional
|
Both
|
$3,195.01
|
|
|
Service Code
|
HCPCS 93451 TC
|
| Min. Negotiated Rate |
$370.63 |
| Max. Negotiated Rate |
$1,807.29 |
| Rate for Payer: Amida Care Medicaid |
$370.63
|
| Rate for Payer: Cash Price |
$852.96
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$803.24
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$722.92
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$722.92
|
| Rate for Payer: Fidelis Essential Plan QHP |
$763.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$803.24
|
| Rate for Payer: Fidelis Qualified Health Plan |
$763.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$803.24
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$803.24
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$602.43
|
| Rate for Payer: Healthfirst Commercial |
$803.24
|
| Rate for Payer: Healthfirst Essential Plan |
$1,807.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$763.08
|
| Rate for Payer: Healthfirst QHP |
$803.24
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$562.27
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$803.24
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$682.75
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$562.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$803.24
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$602.43
|
| Rate for Payer: SOMOS Essential |
$602.43
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$803.24
|
|
|
PR RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT
|
Professional
|
Both
|
$557.83
|
|
|
Service Code
|
HCPCS 93451 26
|
| Min. Negotiated Rate |
$103.60 |
| Max. Negotiated Rate |
$370.63 |
| Rate for Payer: Amida Care Medicaid |
$370.63
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$148.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$133.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$133.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$140.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$148.00
|
| Rate for Payer: Fidelis Qualified Health Plan |
$140.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$148.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$148.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$111.00
|
| Rate for Payer: Healthfirst Commercial |
$148.00
|
| Rate for Payer: Healthfirst Essential Plan |
$333.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$140.60
|
| Rate for Payer: Healthfirst QHP |
$148.00
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$103.60
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$148.00
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$125.80
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$103.60
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$148.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$111.00
|
| Rate for Payer: SOMOS Essential |
$111.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$148.00
|
|
|
PR RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT
|
Professional
|
Both
|
$3,752.84
|
|
|
Service Code
|
HCPCS 93451
|
| Min. Negotiated Rate |
$370.63 |
| Max. Negotiated Rate |
$2,140.29 |
| Rate for Payer: Amida Care Medicaid |
$370.63
|
| Rate for Payer: Cash Price |
$1,001.76
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$951.24
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$856.12
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$856.12
|
| Rate for Payer: Fidelis Essential Plan QHP |
$903.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$951.24
|
| Rate for Payer: Fidelis Qualified Health Plan |
$903.68
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$951.24
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$951.24
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$713.43
|
| Rate for Payer: Healthfirst Commercial |
$951.24
|
| Rate for Payer: Healthfirst Essential Plan |
$2,140.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$903.68
|
| Rate for Payer: Healthfirst QHP |
$951.24
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$665.87
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$951.24
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$808.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$665.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$951.24
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$713.43
|
| Rate for Payer: SOMOS Essential |
$713.43
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$951.24
|
|
|
PR RIGHT VENTRICULAR RECORDING
|
Professional
|
Both
|
$344.33
|
|
|
Service Code
|
HCPCS 93603 TC
|
| Min. Negotiated Rate |
$144.91 |
| Max. Negotiated Rate |
$144.91 |
| Rate for Payer: Amida Care Medicaid |
$144.91
|
|
|
PR RIGHT VENTRICULAR RECORDING
|
Professional
|
Both
|
$490.39
|
|
|
Service Code
|
HCPCS 93603 26
|
| Min. Negotiated Rate |
$90.55 |
| Max. Negotiated Rate |
$291.06 |
| Rate for Payer: Amida Care Medicaid |
$144.91
|
| Rate for Payer: Cash Price |
$129.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$129.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$116.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$116.42
|
| Rate for Payer: Fidelis Essential Plan QHP |
$122.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$129.36
|
| Rate for Payer: Fidelis Qualified Health Plan |
$122.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$129.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$129.36
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$97.02
|
| Rate for Payer: Healthfirst Commercial |
$129.36
|
| Rate for Payer: Healthfirst Essential Plan |
$291.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$122.89
|
| Rate for Payer: Healthfirst QHP |
$129.36
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$90.55
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$129.36
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$109.96
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$90.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$129.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$97.02
|
| Rate for Payer: SOMOS Essential |
$97.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$129.36
|
|
|
PR RIGHT VENTRICULAR RECORDING
|
Professional
|
Both
|
$834.72
|
|
|
Service Code
|
HCPCS 93603
|
| Min. Negotiated Rate |
$144.91 |
| Max. Negotiated Rate |
$144.91 |
| Rate for Payer: Amida Care Medicaid |
$144.91
|
|
|
PR RIMPLTJ VISC ART INFRARNL AORTIC PROSTH EA ART
|
Professional
|
Both
|
$651.81
|
|
|
Service Code
|
HCPCS 35697
|
| Min. Negotiated Rate |
$118.87 |
| Max. Negotiated Rate |
$382.10 |
| Rate for Payer: Cash Price |
$171.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$169.82
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$152.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$152.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$161.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$169.82
|
| Rate for Payer: Fidelis Qualified Health Plan |
$161.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$169.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$169.82
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$127.36
|
| Rate for Payer: Healthfirst Commercial |
$169.82
|
| Rate for Payer: Healthfirst Essential Plan |
$382.10
|
| Rate for Payer: Healthfirst Medicare Advantage |
$161.33
|
| Rate for Payer: Healthfirst QHP |
$169.82
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$118.87
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$169.82
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$144.35
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$118.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$169.82
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$127.36
|
| Rate for Payer: SOMOS Essential |
$127.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$169.82
|
|
|
PR RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF
|
Professional
|
Both
|
$3,422.86
|
|
|
Service Code
|
HCPCS 24342
|
| Min. Negotiated Rate |
$645.00 |
| Max. Negotiated Rate |
$2,073.22 |
| Rate for Payer: Cash Price |
$925.13
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$921.43
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$829.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$829.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$875.36
|
| Rate for Payer: Fidelis Medicare Advantage |
$921.43
|
| Rate for Payer: Fidelis Qualified Health Plan |
$875.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$921.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$921.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$691.07
|
| Rate for Payer: Healthfirst Commercial |
$921.43
|
| Rate for Payer: Healthfirst Essential Plan |
$2,073.22
|
| Rate for Payer: Healthfirst Medicare Advantage |
$875.36
|
| Rate for Payer: Healthfirst QHP |
$921.43
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$645.00
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$921.43
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$783.22
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$645.00
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$921.43
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$691.07
|
| Rate for Payer: SOMOS Essential |
$691.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$921.43
|
|
|
PR R&L HRT CATH CHD IMG CATH TRGT ZON ABNL NT CONNJ
|
Professional
|
Both
|
$1,655.82
|
|
|
Service Code
|
HCPCS 93597 26
|
| Min. Negotiated Rate |
$310.86 |
| Max. Negotiated Rate |
$999.20 |
| Rate for Payer: Cash Price |
$452.21
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$444.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$399.68
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$399.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$421.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$444.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$421.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$444.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$444.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$333.07
|
| Rate for Payer: Healthfirst Commercial |
$444.09
|
| Rate for Payer: Healthfirst Essential Plan |
$999.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$421.89
|
| Rate for Payer: Healthfirst QHP |
$444.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$310.86
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$444.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$377.48
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$310.86
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$444.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$333.07
|
| Rate for Payer: SOMOS Essential |
$333.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$444.09
|
|
|
PR R&L HRT CATH CHD IMG CATH TRGT ZONE NML NT CONNJ
|
Professional
|
Both
|
$1,257.87
|
|
|
Service Code
|
HCPCS 93596 26
|
| Min. Negotiated Rate |
$239.24 |
| Max. Negotiated Rate |
$768.98 |
| Rate for Payer: Cash Price |
$345.58
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$341.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$307.59
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$307.59
|
| Rate for Payer: Fidelis Essential Plan QHP |
$324.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$341.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$324.68
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$341.77
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$341.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$256.33
|
| Rate for Payer: Healthfirst Commercial |
$341.77
|
| Rate for Payer: Healthfirst Essential Plan |
$768.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$324.68
|
| Rate for Payer: Healthfirst QHP |
$341.77
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$239.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$341.77
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$290.50
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$239.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$341.77
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$256.33
|
| Rate for Payer: SOMOS Essential |
$256.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$341.77
|
|
|
PR R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I
|
Professional
|
Both
|
$1,768.06
|
|
|
Service Code
|
HCPCS 93461 26
|
| Min. Negotiated Rate |
$327.08 |
| Max. Negotiated Rate |
$1,051.34 |
| Rate for Payer: Amida Care Medicaid |
$689.52
|
| Rate for Payer: Cash Price |
$472.68
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$467.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$420.53
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$420.53
|
| Rate for Payer: Fidelis Essential Plan QHP |
$443.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$467.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$443.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$467.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$467.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$350.44
|
| Rate for Payer: Healthfirst Commercial |
$467.26
|
| Rate for Payer: Healthfirst Essential Plan |
$1,051.34
|
| Rate for Payer: Healthfirst Medicare Advantage |
$443.90
|
| Rate for Payer: Healthfirst QHP |
$467.26
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$327.08
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$467.26
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$397.17
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$327.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$467.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$350.44
|
| Rate for Payer: SOMOS Essential |
$350.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$467.26
|
|
|
PR R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I
|
Professional
|
Both
|
$4,183.73
|
|
|
Service Code
|
HCPCS 93461 TC
|
| Min. Negotiated Rate |
$689.52 |
| Max. Negotiated Rate |
$2,376.88 |
| Rate for Payer: Amida Care Medicaid |
$689.52
|
| Rate for Payer: Cash Price |
$1,120.30
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,056.39
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$950.75
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$950.75
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,003.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,056.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,003.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,056.39
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,056.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$792.29
|
| Rate for Payer: Healthfirst Commercial |
$1,056.39
|
| Rate for Payer: Healthfirst Essential Plan |
$2,376.88
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,003.57
|
| Rate for Payer: Healthfirst QHP |
$1,056.39
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$739.47
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,056.39
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$897.93
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$739.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,056.39
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$792.29
|
| Rate for Payer: SOMOS Essential |
$792.29
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,056.39
|
|
|
PR R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I
|
Professional
|
Both
|
$5,951.79
|
|
|
Service Code
|
HCPCS 93461
|
| Min. Negotiated Rate |
$689.52 |
| Max. Negotiated Rate |
$3,428.21 |
| Rate for Payer: Amida Care Medicaid |
$689.52
|
| Rate for Payer: Cash Price |
$1,592.99
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,523.65
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,371.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,371.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,447.47
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,523.65
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,447.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,523.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,523.65
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,142.74
|
| Rate for Payer: Healthfirst Commercial |
$1,523.65
|
| Rate for Payer: Healthfirst Essential Plan |
$3,428.21
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,447.47
|
| Rate for Payer: Healthfirst QHP |
$1,523.65
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,066.56
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,523.65
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,295.10
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,066.56
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,523.65
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,142.74
|
| Rate for Payer: SOMOS Essential |
$1,142.74
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,523.65
|
|
|
PR R & L HRT CATH WINJX HRT ART& L VENTR IMG
|
Professional
|
Both
|
$5,394.31
|
|
|
Service Code
|
HCPCS 93460
|
| Min. Negotiated Rate |
$601.40 |
| Max. Negotiated Rate |
$3,107.81 |
| Rate for Payer: Amida Care Medicaid |
$601.40
|
| Rate for Payer: Cash Price |
$1,443.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,381.25
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,243.12
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,243.12
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,312.19
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,381.25
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,312.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,381.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,381.25
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,035.94
|
| Rate for Payer: Healthfirst Commercial |
$1,381.25
|
| Rate for Payer: Healthfirst Essential Plan |
$3,107.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,312.19
|
| Rate for Payer: Healthfirst QHP |
$1,381.25
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$966.88
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,381.25
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,174.06
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$966.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,381.25
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,035.94
|
| Rate for Payer: SOMOS Essential |
$1,035.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,381.25
|
|
