|
CHG HYPERTHERMIA INTRACAVITARY PROBES
|
Professional
|
Both
|
$371.81
|
|
|
Service Code
|
HCPCS 77620 26
|
| Min. Negotiated Rate |
$68.36 |
| Max. Negotiated Rate |
$219.74 |
| Rate for Payer: Cash Price |
$98.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$97.66
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$87.89
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$87.89
|
| Rate for Payer: Fidelis Essential Plan QHP |
$92.78
|
| Rate for Payer: Fidelis Medicare Advantage |
$97.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$92.78
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$97.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$97.66
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$73.25
|
| Rate for Payer: Healthfirst Commercial |
$97.66
|
| Rate for Payer: Healthfirst Essential Plan |
$219.74
|
| Rate for Payer: Healthfirst Medicare Advantage |
$92.78
|
| Rate for Payer: Healthfirst QHP |
$97.66
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$68.36
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$97.66
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$83.01
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$68.36
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$97.66
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$73.25
|
| Rate for Payer: SOMOS Essential |
$73.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$97.66
|
|
|
CHG HYPERTHERMIA INTRACAVITARY PROBES
|
Professional
|
Both
|
$2,408.42
|
|
|
Service Code
|
HCPCS 77620 TC
|
| Min. Negotiated Rate |
$447.38 |
| Max. Negotiated Rate |
$1,438.02 |
| Rate for Payer: Cash Price |
$655.86
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$639.12
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$575.21
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$575.21
|
| Rate for Payer: Fidelis Essential Plan QHP |
$607.16
|
| Rate for Payer: Fidelis Medicare Advantage |
$639.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$607.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$639.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$639.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$479.34
|
| Rate for Payer: Healthfirst Commercial |
$639.12
|
| Rate for Payer: Healthfirst Essential Plan |
$1,438.02
|
| Rate for Payer: Healthfirst Medicare Advantage |
$607.16
|
| Rate for Payer: Healthfirst QHP |
$639.12
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$447.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$639.12
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$543.25
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$447.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$639.12
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$479.34
|
| Rate for Payer: SOMOS Essential |
$479.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$639.12
|
|
|
CHG HYSTEROSALPINGOGRAPHY RS&I
|
Professional
|
Both
|
$410.87
|
|
|
Service Code
|
HCPCS 74740
|
| Min. Negotiated Rate |
$72.95 |
| Max. Negotiated Rate |
$234.50 |
| Rate for Payer: Cash Price |
$109.43
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$104.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$93.80
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$93.80
|
| Rate for Payer: Fidelis Essential Plan QHP |
$99.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$104.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$99.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$104.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$104.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$78.17
|
| Rate for Payer: Healthfirst Commercial |
$104.22
|
| Rate for Payer: Healthfirst Essential Plan |
$234.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$99.01
|
| Rate for Payer: Healthfirst QHP |
$104.22
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$72.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$104.22
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$88.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$72.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$104.22
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$78.17
|
| Rate for Payer: SOMOS Essential |
$78.17
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$104.22
|
|
|
CHG HYSTEROSALPINGOGRAPHY RS&I
|
Professional
|
Both
|
$337.68
|
|
|
Service Code
|
HCPCS 74740 TC
|
| Min. Negotiated Rate |
$59.12 |
| Max. Negotiated Rate |
$190.03 |
| Rate for Payer: Cash Price |
$89.43
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$84.46
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$76.01
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$76.01
|
| Rate for Payer: Fidelis Essential Plan QHP |
$80.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$84.46
|
| Rate for Payer: Fidelis Qualified Health Plan |
$80.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$84.46
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$84.46
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$63.34
|
| Rate for Payer: Healthfirst Commercial |
$84.46
|
| Rate for Payer: Healthfirst Essential Plan |
$190.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$80.24
|
| Rate for Payer: Healthfirst QHP |
$84.46
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$59.12
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$84.46
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$71.79
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$59.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$84.46
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$63.34
|
| Rate for Payer: SOMOS Essential |
$63.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$84.46
|
|
|
CHG HYSTEROSALPINGOGRAPHY RS&I
|
Professional
|
Both
|
$73.19
|
|
|
Service Code
|
HCPCS 74740 26
|
| Min. Negotiated Rate |
$13.83 |
| Max. Negotiated Rate |
$44.46 |
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$19.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$17.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$18.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$19.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$18.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$19.76
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$14.82
|
| Rate for Payer: Healthfirst Commercial |
$19.76
|
| Rate for Payer: Healthfirst Essential Plan |
$44.46
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18.77
|
| Rate for Payer: Healthfirst QHP |
$19.76
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$13.83
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$19.76
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$16.80
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$13.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$19.76
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$14.82
|
| Rate for Payer: SOMOS Essential |
$14.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$19.76
|
|
|
CHG IAADIADOO INFLUENZA
|
Professional
|
Both
|
$66.20
|
|
|
Service Code
|
HCPCS 87804
|
| Min. Negotiated Rate |
$6.62 |
| Max. Negotiated Rate |
$37.24 |
| Rate for Payer: Cash Price |
$16.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$16.55
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$14.89
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$14.89
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.72
|
| Rate for Payer: Fidelis Medicare Advantage |
$16.55
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.72
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.55
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.41
|
| Rate for Payer: Healthfirst Commercial |
$16.55
|
| Rate for Payer: Healthfirst Essential Plan |
$37.24
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.72
|
| Rate for Payer: Healthfirst QHP |
$16.55
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$11.59
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$16.55
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$14.07
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$11.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$16.55
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$6.62
|
| Rate for Payer: SOMOS Essential |
$6.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16.55
|
|
|
CHG IAADIADOO STREPTOCOCCUS GROUP A
|
Professional
|
Both
|
$41.32
|
|
|
Service Code
|
HCPCS 87880
|
| Min. Negotiated Rate |
$6.61 |
| Max. Negotiated Rate |
$37.19 |
| Rate for Payer: Cash Price |
$16.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$16.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$14.88
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$14.88
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$16.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.40
|
| Rate for Payer: Healthfirst Commercial |
$16.53
|
| Rate for Payer: Healthfirst Essential Plan |
$37.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.70
|
| Rate for Payer: Healthfirst QHP |
$16.53
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$11.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$16.53
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$14.05
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$11.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$16.53
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$6.61
|
| Rate for Payer: SOMOS Essential |
$6.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16.53
|
|
|
CHG IMHCHEM/IMCYTCHM 1ST SINGLE ANTB STAIN PROCEDURE
|
Professional
|
Both
|
$418.01
|
|
|
Service Code
|
HCPCS 88342
|
| Min. Negotiated Rate |
$89.75 |
| Max. Negotiated Rate |
$288.47 |
| Rate for Payer: Cash Price |
$122.32
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$128.21
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$115.39
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$115.39
|
| Rate for Payer: Fidelis Essential Plan QHP |
$121.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$128.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$121.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$128.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$128.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$96.16
|
| Rate for Payer: Healthfirst Commercial |
$128.21
|
| Rate for Payer: Healthfirst Essential Plan |
$288.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$121.80
|
| Rate for Payer: Healthfirst QHP |
$128.21
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$89.75
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$128.21
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$108.98
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$89.75
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$128.21
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$96.16
|
| Rate for Payer: SOMOS Essential |
$96.16
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$128.21
|
|
|
CHG IMHCHEM/IMCYTCHM 1ST SINGLE ANTB STAIN PROCEDURE
|
Professional
|
Both
|
$133.53
|
|
|
Service Code
|
HCPCS 88342 26
|
| Min. Negotiated Rate |
$25.47 |
| Max. Negotiated Rate |
$81.86 |
| Rate for Payer: Cash Price |
$36.82
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$36.38
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$32.74
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$32.74
|
| Rate for Payer: Fidelis Essential Plan QHP |
$34.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$36.38
|
| Rate for Payer: Fidelis Qualified Health Plan |
$34.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$36.38
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$36.38
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$27.29
|
| Rate for Payer: Healthfirst Commercial |
$36.38
|
| Rate for Payer: Healthfirst Essential Plan |
$81.86
|
| Rate for Payer: Healthfirst Medicare Advantage |
$34.56
|
| Rate for Payer: Healthfirst QHP |
$36.38
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$25.47
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$36.38
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$30.92
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$25.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$36.38
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$27.29
|
| Rate for Payer: SOMOS Essential |
$27.29
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$36.38
|
|
|
CHG IMHCHEM/IMCYTCHM 1ST SINGLE ANTB STAIN PROCEDURE
|
Professional
|
Both
|
$284.48
|
|
|
Service Code
|
HCPCS 88342 TC
|
| Min. Negotiated Rate |
$64.29 |
| Max. Negotiated Rate |
$206.64 |
| Rate for Payer: Cash Price |
$85.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$91.84
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$82.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$82.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$87.25
|
| Rate for Payer: Fidelis Medicare Advantage |
$91.84
|
| Rate for Payer: Fidelis Qualified Health Plan |
$87.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$91.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$91.84
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$68.88
|
| Rate for Payer: Healthfirst Commercial |
$91.84
|
| Rate for Payer: Healthfirst Essential Plan |
$206.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$87.25
|
| Rate for Payer: Healthfirst QHP |
$91.84
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$64.29
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$91.84
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$78.06
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$64.29
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$91.84
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$68.88
|
| Rate for Payer: SOMOS Essential |
$68.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$91.84
|
|
|
CHG IMHCHEM/IMCYTCHM EA ADDL SINGLE ANTB STAIN PX
|
Professional
|
Both
|
$108.82
|
|
|
Service Code
|
HCPCS 88341 26
|
| Min. Negotiated Rate |
$20.73 |
| Max. Negotiated Rate |
$66.62 |
| Rate for Payer: Cash Price |
$29.58
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$29.61
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$26.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$26.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$28.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$29.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$28.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$29.61
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$29.61
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$22.21
|
| Rate for Payer: Healthfirst Commercial |
$29.61
|
| Rate for Payer: Healthfirst Essential Plan |
$66.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$28.13
|
| Rate for Payer: Healthfirst QHP |
$29.61
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$20.73
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$29.61
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$25.17
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$20.73
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$29.61
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$22.21
|
| Rate for Payer: SOMOS Essential |
$22.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$29.61
|
|
|
CHG IMHCHEM/IMCYTCHM EA ADDL SINGLE ANTB STAIN PX
|
Professional
|
Both
|
$360.36
|
|
|
Service Code
|
HCPCS 88341
|
| Min. Negotiated Rate |
$76.97 |
| Max. Negotiated Rate |
$247.41 |
| Rate for Payer: Cash Price |
$104.63
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$109.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$98.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$98.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$104.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$109.96
|
| Rate for Payer: Fidelis Qualified Health Plan |
$104.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$109.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$109.96
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$82.47
|
| Rate for Payer: Healthfirst Commercial |
$109.96
|
| Rate for Payer: Healthfirst Essential Plan |
$247.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$104.46
|
| Rate for Payer: Healthfirst QHP |
$109.96
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$76.97
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$109.96
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$93.47
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$76.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$109.96
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$82.47
|
| Rate for Payer: SOMOS Essential |
$82.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$109.96
|
|
|
CHG IMHCHEM/IMCYTCHM EA ADDL SINGLE ANTB STAIN PX
|
Professional
|
Both
|
$251.55
|
|
|
Service Code
|
HCPCS 88341 TC
|
| Min. Negotiated Rate |
$56.24 |
| Max. Negotiated Rate |
$180.79 |
| Rate for Payer: Cash Price |
$75.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$80.35
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$72.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$72.31
|
| Rate for Payer: Fidelis Essential Plan QHP |
$76.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$80.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$76.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$80.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$80.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$60.26
|
| Rate for Payer: Healthfirst Commercial |
$80.35
|
| Rate for Payer: Healthfirst Essential Plan |
$180.79
|
| Rate for Payer: Healthfirst Medicare Advantage |
$76.33
|
| Rate for Payer: Healthfirst QHP |
$80.35
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$56.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$80.35
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$68.30
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$56.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$80.35
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$60.26
|
| Rate for Payer: SOMOS Essential |
$60.26
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$80.35
|
|
|
CHG IMHCHEM/IMCYTCHM EA MULTIPLEX ANTIBODY STAIN PX
|
Professional
|
Both
|
$708.54
|
|
|
Service Code
|
HCPCS 88344
|
| Min. Negotiated Rate |
$138.45 |
| Max. Negotiated Rate |
$445.00 |
| Rate for Payer: Cash Price |
$200.99
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$197.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$178.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$178.00
|
| Rate for Payer: Fidelis Essential Plan QHP |
$187.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$197.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$187.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$197.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$197.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$148.34
|
| Rate for Payer: Healthfirst Commercial |
$197.78
|
| Rate for Payer: Healthfirst Essential Plan |
$445.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$187.89
|
| Rate for Payer: Healthfirst QHP |
$197.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$138.45
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$197.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$168.11
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$138.45
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$197.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$148.34
|
| Rate for Payer: SOMOS Essential |
$148.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$197.78
|
|
|
CHG IMHCHEM/IMCYTCHM EA MULTIPLEX ANTIBODY STAIN PX
|
Professional
|
Both
|
$561.93
|
|
|
Service Code
|
HCPCS 88344 TC
|
| Min. Negotiated Rate |
$110.20 |
| Max. Negotiated Rate |
$354.22 |
| Rate for Payer: Cash Price |
$160.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$157.43
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$141.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$141.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$149.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$157.43
|
| Rate for Payer: Fidelis Qualified Health Plan |
$149.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$157.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$157.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$118.07
|
| Rate for Payer: Healthfirst Commercial |
$157.43
|
| Rate for Payer: Healthfirst Essential Plan |
$354.22
|
| Rate for Payer: Healthfirst Medicare Advantage |
$149.56
|
| Rate for Payer: Healthfirst QHP |
$157.43
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$110.20
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$157.43
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$133.82
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$110.20
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$157.43
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$118.07
|
| Rate for Payer: SOMOS Essential |
$118.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$157.43
|
|
|
CHG IMHCHEM/IMCYTCHM EA MULTIPLEX ANTIBODY STAIN PX
|
Professional
|
Both
|
$146.62
|
|
|
Service Code
|
HCPCS 88344 26
|
| Min. Negotiated Rate |
$28.24 |
| Max. Negotiated Rate |
$90.77 |
| Rate for Payer: Cash Price |
$40.44
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$40.34
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$36.31
|
| Rate for Payer: Fidelis Essential Plan QHP |
$38.32
|
| Rate for Payer: Fidelis Medicare Advantage |
$40.34
|
| Rate for Payer: Fidelis Qualified Health Plan |
$38.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40.34
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$40.34
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30.25
|
| Rate for Payer: Healthfirst Commercial |
$40.34
|
| Rate for Payer: Healthfirst Essential Plan |
$90.77
|
| Rate for Payer: Healthfirst Medicare Advantage |
$38.32
|
| Rate for Payer: Healthfirst QHP |
$40.34
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$28.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$40.34
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$34.29
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$28.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$40.34
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$30.25
|
| Rate for Payer: SOMOS Essential |
$30.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$40.34
|
|
|
CHG IMMUNOELECTROPHORESIS CROSSED
|
Professional
|
Both
|
$85.54
|
|
|
Service Code
|
HCPCS 86327 26
|
| Rate for Payer: Cash Price |
$23.13
|
|
|
CHG IMMUNOELECTROPHORESIS OTHER FLUIDS CONCENTRATION
|
Professional
|
Both
|
$69.20
|
|
|
Service Code
|
HCPCS 86325 26
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$43.18 |
| Rate for Payer: Cash Price |
$19.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$19.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$17.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$18.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$19.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$18.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$19.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$14.39
|
| Rate for Payer: Healthfirst Commercial |
$19.19
|
| Rate for Payer: Healthfirst Essential Plan |
$43.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18.23
|
| Rate for Payer: Healthfirst QHP |
$19.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$13.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$19.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$16.31
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$13.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$19.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$7.68
|
| Rate for Payer: SOMOS Essential |
$7.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$19.19
|
|
|
CHG IMMUNOELECTROPHORESIS SERUM
|
Professional
|
Both
|
$69.20
|
|
|
Service Code
|
HCPCS 86320 26
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$43.18 |
| Rate for Payer: Cash Price |
$19.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$19.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$17.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$18.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$19.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$18.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$19.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$14.39
|
| Rate for Payer: Healthfirst Commercial |
$19.19
|
| Rate for Payer: Healthfirst Essential Plan |
$43.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18.23
|
| Rate for Payer: Healthfirst QHP |
$19.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$13.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$19.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$16.31
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$13.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$19.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$7.68
|
| Rate for Payer: SOMOS Essential |
$7.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$19.19
|
|
|
CHG IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS
|
Professional
|
Both
|
$69.20
|
|
|
Service Code
|
HCPCS 86335 26
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$43.18 |
| Rate for Payer: Cash Price |
$19.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$19.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$17.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$18.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$19.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$18.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$19.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$14.39
|
| Rate for Payer: Healthfirst Commercial |
$19.19
|
| Rate for Payer: Healthfirst Essential Plan |
$43.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18.23
|
| Rate for Payer: Healthfirst QHP |
$19.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$13.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$19.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$16.31
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$13.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$19.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$7.68
|
| Rate for Payer: SOMOS Essential |
$7.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$19.19
|
|
|
CHG IMMUNOFIXJ ELECTROPHORESIS SERUM
|
Professional
|
Both
|
$69.20
|
|
|
Service Code
|
HCPCS 86334 26
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$43.18 |
| Rate for Payer: Cash Price |
$19.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$19.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$17.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$17.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$18.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$19.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$18.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$19.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$19.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$14.39
|
| Rate for Payer: Healthfirst Commercial |
$19.19
|
| Rate for Payer: Healthfirst Essential Plan |
$43.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$18.23
|
| Rate for Payer: Healthfirst QHP |
$19.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$13.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$19.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$16.31
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$13.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$19.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$7.68
|
| Rate for Payer: SOMOS Essential |
$7.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$19.19
|
|
|
CHG IMMUNOFLUORESCENCE PER SPEC 1ST SINGLE ANTB STN
|
Professional
|
Both
|
$502.99
|
|
|
Service Code
|
HCPCS 88346 TC
|
| Min. Negotiated Rate |
$89.71 |
| Max. Negotiated Rate |
$288.36 |
| Rate for Payer: Cash Price |
$136.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$128.16
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$115.34
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$115.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$121.75
|
| Rate for Payer: Fidelis Medicare Advantage |
$128.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$121.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$128.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$128.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$96.12
|
| Rate for Payer: Healthfirst Commercial |
$128.16
|
| Rate for Payer: Healthfirst Essential Plan |
$288.36
|
| Rate for Payer: Healthfirst Medicare Advantage |
$121.75
|
| Rate for Payer: Healthfirst QHP |
$128.16
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$89.71
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$128.16
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$108.94
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$89.71
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$128.16
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$96.12
|
| Rate for Payer: SOMOS Essential |
$96.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$128.16
|
|
|
CHG IMMUNOFLUORESCENCE PER SPEC 1ST SINGLE ANTB STN
|
Professional
|
Both
|
$137.10
|
|
|
Service Code
|
HCPCS 88346 26
|
| Min. Negotiated Rate |
$26.16 |
| Max. Negotiated Rate |
$84.08 |
| Rate for Payer: Cash Price |
$37.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$37.37
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$33.63
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$33.63
|
| Rate for Payer: Fidelis Essential Plan QHP |
$35.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$37.37
|
| Rate for Payer: Fidelis Qualified Health Plan |
$35.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$37.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$37.37
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$28.03
|
| Rate for Payer: Healthfirst Commercial |
$37.37
|
| Rate for Payer: Healthfirst Essential Plan |
$84.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$35.50
|
| Rate for Payer: Healthfirst QHP |
$37.37
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$26.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$37.37
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$31.76
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$26.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$37.37
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$28.03
|
| Rate for Payer: SOMOS Essential |
$28.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$37.37
|
|
|
CHG IMMUNOFLUORESCENCE PER SPEC 1ST SINGLE ANTB STN
|
Professional
|
Both
|
$640.08
|
|
|
Service Code
|
HCPCS 88346
|
| Min. Negotiated Rate |
$115.87 |
| Max. Negotiated Rate |
$372.44 |
| Rate for Payer: Cash Price |
$174.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$165.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$148.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$148.98
|
| Rate for Payer: Fidelis Essential Plan QHP |
$157.25
|
| Rate for Payer: Fidelis Medicare Advantage |
$165.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$157.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$165.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$165.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$124.15
|
| Rate for Payer: Healthfirst Commercial |
$165.53
|
| Rate for Payer: Healthfirst Essential Plan |
$372.44
|
| Rate for Payer: Healthfirst Medicare Advantage |
$157.25
|
| Rate for Payer: Healthfirst QHP |
$165.53
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$115.87
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$165.53
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$140.70
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$115.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$165.53
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$124.15
|
| Rate for Payer: SOMOS Essential |
$124.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$165.53
|
|
|
CHG IMMUNOFLUORESCENCE PR SPEC EA ADD SINGL ANTB STN
|
Professional
|
Both
|
$111.13
|
|
|
Service Code
|
HCPCS 88350 26
|
| Min. Negotiated Rate |
$21.18 |
| Max. Negotiated Rate |
$68.08 |
| Rate for Payer: Cash Price |
$30.63
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$30.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$27.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$27.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$28.75
|
| Rate for Payer: Fidelis Medicare Advantage |
$30.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$28.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$22.70
|
| Rate for Payer: Healthfirst Commercial |
$30.26
|
| Rate for Payer: Healthfirst Essential Plan |
$68.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$28.75
|
| Rate for Payer: Healthfirst QHP |
$30.26
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$21.18
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$30.26
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$25.72
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$21.18
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$30.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$22.70
|
| Rate for Payer: SOMOS Essential |
$22.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$30.26
|
|
