|
PR RPR NONUNION SCAPHOID CARPAL BNE W/WO RDL STYLEC
|
Professional
|
Both
|
$3,386.18
|
|
|
Service Code
|
HCPCS 25440
|
| Min. Negotiated Rate |
$641.11 |
| Max. Negotiated Rate |
$2,060.71 |
| Rate for Payer: Cash Price |
$918.56
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$915.87
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$824.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$824.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$870.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$915.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$870.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$915.87
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$915.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$686.90
|
| Rate for Payer: Healthfirst Commercial |
$915.87
|
| Rate for Payer: Healthfirst Essential Plan |
$2,060.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$870.08
|
| Rate for Payer: Healthfirst QHP |
$915.87
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$641.11
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$915.87
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$778.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$641.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$915.87
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$686.90
|
| Rate for Payer: SOMOS Essential |
$686.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$915.87
|
|
|
PR RPR NSL VLV COLLAPSE LW NRG SUBQ/SBMCSL RMDLG
|
Professional
|
Both
|
$644.32
|
|
|
Service Code
|
HCPCS 30469
|
| Min. Negotiated Rate |
$120.88 |
| Max. Negotiated Rate |
$388.53 |
| Rate for Payer: Cash Price |
$174.81
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$172.68
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$155.41
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$155.41
|
| Rate for Payer: Fidelis Essential Plan QHP |
$164.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$172.68
|
| Rate for Payer: Fidelis Qualified Health Plan |
$164.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$172.68
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$172.68
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$129.51
|
| Rate for Payer: Healthfirst Commercial |
$172.68
|
| Rate for Payer: Healthfirst Essential Plan |
$388.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$164.05
|
| Rate for Payer: Healthfirst QHP |
$172.68
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$120.88
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$172.68
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$146.78
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$120.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$172.68
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$129.51
|
| Rate for Payer: SOMOS Essential |
$129.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$172.68
|
|
|
PR RPR NSL VLV COLLAPSE SUBQ/SBMCSL LAT WALL IMPLT
|
Professional
|
Both
|
$726.08
|
|
|
Service Code
|
HCPCS 30468
|
| Min. Negotiated Rate |
$136.18 |
| Max. Negotiated Rate |
$437.71 |
| Rate for Payer: Cash Price |
$195.76
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$194.54
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$175.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$175.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$184.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$194.54
|
| Rate for Payer: Fidelis Qualified Health Plan |
$184.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$194.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$194.54
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$145.91
|
| Rate for Payer: Healthfirst Commercial |
$194.54
|
| Rate for Payer: Healthfirst Essential Plan |
$437.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$184.81
|
| Rate for Payer: Healthfirst QHP |
$194.54
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$136.18
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$194.54
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$165.36
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$136.18
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$194.54
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$145.91
|
| Rate for Payer: SOMOS Essential |
$145.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$194.54
|
|
|
PR RPR OMPHALOCELE GROSS TYP OPRATION 1ST STG
|
Professional
|
Both
|
$3,149.72
|
|
|
Service Code
|
HCPCS 49610
|
| Min. Negotiated Rate |
$585.26 |
| Max. Negotiated Rate |
$1,881.18 |
| Rate for Payer: Cash Price |
$840.31
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$836.08
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$752.47
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$752.47
|
| Rate for Payer: Fidelis Essential Plan QHP |
$794.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$836.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$794.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$836.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$836.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$627.06
|
| Rate for Payer: Healthfirst Commercial |
$836.08
|
| Rate for Payer: Healthfirst Essential Plan |
$1,881.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$794.28
|
| Rate for Payer: Healthfirst QHP |
$836.08
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$585.26
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$836.08
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$710.67
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$585.26
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$836.08
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$627.06
|
| Rate for Payer: SOMOS Essential |
$627.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$836.08
|
|
|
PR RPR OMPHALOCELE GROSS TYP OPRATION 2ND STG
|
Professional
|
Both
|
$2,773.05
|
|
|
Service Code
|
HCPCS 49611
|
| Min. Negotiated Rate |
$515.69 |
| Max. Negotiated Rate |
$1,657.58 |
| Rate for Payer: Cash Price |
$740.88
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$736.70
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$663.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$663.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$699.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$736.70
|
| Rate for Payer: Fidelis Qualified Health Plan |
$699.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$736.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$736.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$552.52
|
| Rate for Payer: Healthfirst Commercial |
$736.70
|
| Rate for Payer: Healthfirst Essential Plan |
$1,657.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$699.87
|
| Rate for Payer: Healthfirst QHP |
$736.70
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$515.69
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$736.70
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$626.20
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$515.69
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$736.70
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$552.52
|
| Rate for Payer: SOMOS Essential |
$552.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$736.70
|
|
|
PR RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/MESH
|
Professional
|
Both
|
$6,887.06
|
|
|
Service Code
|
HCPCS 43337
|
| Min. Negotiated Rate |
$1,267.82 |
| Max. Negotiated Rate |
$4,075.13 |
| Rate for Payer: Cash Price |
$1,829.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,811.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,630.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,630.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,720.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,811.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,720.61
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,811.17
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,811.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,358.38
|
| Rate for Payer: Healthfirst Commercial |
$1,811.17
|
| Rate for Payer: Healthfirst Essential Plan |
$4,075.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,720.61
|
| Rate for Payer: Healthfirst QHP |
$1,811.17
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,267.82
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,811.17
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,539.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,267.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,811.17
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,358.38
|
| Rate for Payer: SOMOS Essential |
$1,358.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,811.17
|
|
|
PR RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH
|
Professional
|
Both
|
$6,461.46
|
|
|
Service Code
|
HCPCS 43336
|
| Min. Negotiated Rate |
$1,189.68 |
| Max. Negotiated Rate |
$3,823.99 |
| Rate for Payer: Cash Price |
$1,717.52
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,699.55
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,529.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,529.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,614.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,699.55
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,614.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,699.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,699.55
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,274.66
|
| Rate for Payer: Healthfirst Commercial |
$1,699.55
|
| Rate for Payer: Healthfirst Essential Plan |
$3,823.99
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,614.57
|
| Rate for Payer: Healthfirst QHP |
$1,699.55
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,189.68
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,699.55
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,444.62
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,189.68
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,699.55
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,274.66
|
| Rate for Payer: SOMOS Essential |
$1,274.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,699.55
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH
|
Professional
|
Both
|
$5,158.76
|
|
|
Service Code
|
HCPCS 43332
|
| Min. Negotiated Rate |
$953.94 |
| Max. Negotiated Rate |
$3,066.23 |
| Rate for Payer: Cash Price |
$1,376.92
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,362.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,226.49
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,226.49
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,294.63
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,362.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,294.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,362.77
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,362.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,022.08
|
| Rate for Payer: Healthfirst Commercial |
$1,362.77
|
| Rate for Payer: Healthfirst Essential Plan |
$3,066.23
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,294.63
|
| Rate for Payer: Healthfirst QHP |
$1,362.77
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$953.94
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,362.77
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,158.35
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$953.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,362.77
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,022.08
|
| Rate for Payer: SOMOS Essential |
$1,022.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,362.77
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH
|
Professional
|
Both
|
$5,949.62
|
|
|
Service Code
|
HCPCS 43335
|
| Min. Negotiated Rate |
$1,094.87 |
| Max. Negotiated Rate |
$3,519.22 |
| Rate for Payer: Cash Price |
$1,582.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,564.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,407.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,407.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,485.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,564.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,485.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,564.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,564.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,173.08
|
| Rate for Payer: Healthfirst Commercial |
$1,564.10
|
| Rate for Payer: Healthfirst Essential Plan |
$3,519.22
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,485.89
|
| Rate for Payer: Healthfirst QHP |
$1,564.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,094.87
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,564.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,329.48
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,094.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,564.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,173.08
|
| Rate for Payer: SOMOS Essential |
$1,173.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,564.10
|
|
|
PR RPR PARAESOPH HIATAL HERNIA W/THORCOM W/O MESH
|
Professional
|
Both
|
$5,540.57
|
|
|
Service Code
|
HCPCS 43334
|
| Min. Negotiated Rate |
$1,019.70 |
| Max. Negotiated Rate |
$3,277.62 |
| Rate for Payer: Cash Price |
$1,470.54
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,456.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,311.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,311.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,383.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,456.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,383.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,456.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,456.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,092.54
|
| Rate for Payer: Healthfirst Commercial |
$1,456.72
|
| Rate for Payer: Healthfirst Essential Plan |
$3,277.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,383.88
|
| Rate for Payer: Healthfirst QHP |
$1,456.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,019.70
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,456.72
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,238.21
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,019.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,456.72
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,092.54
|
| Rate for Payer: SOMOS Essential |
$1,092.54
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,456.72
|
|
|
PR RPR PARASTOMAL HERNIA 1ST/RECR REDUCIBLE
|
Professional
|
Both
|
$3,305.33
|
|
|
Service Code
|
HCPCS 49621
|
| Min. Negotiated Rate |
$624.15 |
| Max. Negotiated Rate |
$2,006.19 |
| Rate for Payer: Cash Price |
$882.13
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$891.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$802.48
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$802.48
|
| Rate for Payer: Fidelis Essential Plan QHP |
$847.06
|
| Rate for Payer: Fidelis Medicare Advantage |
$891.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$847.06
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$891.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$891.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$668.73
|
| Rate for Payer: Healthfirst Commercial |
$891.64
|
| Rate for Payer: Healthfirst Essential Plan |
$2,006.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$847.06
|
| Rate for Payer: Healthfirst QHP |
$891.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$624.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$891.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$757.89
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$624.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$891.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$668.73
|
| Rate for Payer: SOMOS Essential |
$668.73
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$891.64
|
|
|
PR RPR PARASTOMAL HRNA 1ST/RECR NCRC8/STRANGULATED
|
Professional
|
Both
|
$4,074.67
|
|
|
Service Code
|
HCPCS 49622
|
| Min. Negotiated Rate |
$778.83 |
| Max. Negotiated Rate |
$2,503.39 |
| Rate for Payer: Cash Price |
$1,086.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,112.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,001.36
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,001.36
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,056.99
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,112.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,056.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,112.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,112.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$834.47
|
| Rate for Payer: Healthfirst Commercial |
$1,112.62
|
| Rate for Payer: Healthfirst Essential Plan |
$2,503.39
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,056.99
|
| Rate for Payer: Healthfirst QHP |
$1,112.62
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$778.83
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,112.62
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$945.73
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$778.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,112.62
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$834.47
|
| Rate for Payer: SOMOS Essential |
$834.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,112.62
|
|
|
PR RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/BYPASS
|
Professional
|
Both
|
$10,737.23
|
|
|
Service Code
|
HCPCS 33926
|
| Min. Negotiated Rate |
$1,972.66 |
| Max. Negotiated Rate |
$6,340.70 |
| Rate for Payer: Cash Price |
$2,849.71
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,818.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,536.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,536.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,677.19
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,818.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,677.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,818.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,818.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,113.57
|
| Rate for Payer: Healthfirst Commercial |
$2,818.09
|
| Rate for Payer: Healthfirst Essential Plan |
$6,340.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,677.19
|
| Rate for Payer: Healthfirst QHP |
$2,818.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,972.66
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,818.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,395.38
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,972.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,818.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,113.57
|
| Rate for Payer: SOMOS Essential |
$2,113.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,818.09
|
|
|
PR RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/O BYPASS
|
Professional
|
Both
|
$7,636.48
|
|
|
Service Code
|
HCPCS 33925
|
| Min. Negotiated Rate |
$1,403.86 |
| Max. Negotiated Rate |
$4,512.40 |
| Rate for Payer: Cash Price |
$2,026.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,005.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,804.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,804.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,905.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,005.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,905.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,005.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,005.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,504.13
|
| Rate for Payer: Healthfirst Commercial |
$2,005.51
|
| Rate for Payer: Healthfirst Essential Plan |
$4,512.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,905.23
|
| Rate for Payer: Healthfirst QHP |
$2,005.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,403.86
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,005.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,704.68
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,403.86
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,005.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,504.13
|
| Rate for Payer: SOMOS Essential |
$1,504.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,005.51
|
|
|
PR RPR PATENT DUXUS ARTERIOSUS DIV 18 YR & OLDER
|
Professional
|
Both
|
$5,264.98
|
|
|
Service Code
|
HCPCS 33824
|
| Min. Negotiated Rate |
$973.29 |
| Max. Negotiated Rate |
$3,128.45 |
| Rate for Payer: Cash Price |
$1,403.18
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,390.42
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,251.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,251.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,320.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,390.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,320.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,390.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,390.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,042.82
|
| Rate for Payer: Healthfirst Commercial |
$1,390.42
|
| Rate for Payer: Healthfirst Essential Plan |
$3,128.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,320.90
|
| Rate for Payer: Healthfirst QHP |
$1,390.42
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$973.29
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,390.42
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,181.86
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$973.29
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,390.42
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,042.82
|
| Rate for Payer: SOMOS Essential |
$1,042.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,390.42
|
|
|
PR RPR PATENT DUXUS ARTERIOSUS DIV UNDER 18 YR
|
Professional
|
Both
|
$4,543.81
|
|
|
Service Code
|
HCPCS 33822
|
| Min. Negotiated Rate |
$840.11 |
| Max. Negotiated Rate |
$2,700.34 |
| Rate for Payer: Cash Price |
$1,210.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,200.15
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,080.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,080.13
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,140.14
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,200.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,140.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,200.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,200.15
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$900.11
|
| Rate for Payer: Healthfirst Commercial |
$1,200.15
|
| Rate for Payer: Healthfirst Essential Plan |
$2,700.34
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,140.14
|
| Rate for Payer: Healthfirst QHP |
$1,200.15
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$840.11
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,200.15
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,020.13
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$840.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,200.15
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$900.11
|
| Rate for Payer: SOMOS Essential |
$900.11
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,200.15
|
|
|
PR RPR POSTINFRCJ VENTRICULAR SEPTAL DEFECT
|
Professional
|
Both
|
$13,494.50
|
|
|
Service Code
|
HCPCS 33545
|
| Min. Negotiated Rate |
$2,482.15 |
| Max. Negotiated Rate |
$7,978.34 |
| Rate for Payer: Cash Price |
$3,579.34
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,545.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,191.34
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,191.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,368.63
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,545.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,368.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,545.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,545.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,659.45
|
| Rate for Payer: Healthfirst Commercial |
$3,545.93
|
| Rate for Payer: Healthfirst Essential Plan |
$7,978.34
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,368.63
|
| Rate for Payer: Healthfirst QHP |
$3,545.93
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,482.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,545.93
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$3,014.04
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,482.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,545.93
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,659.45
|
| Rate for Payer: SOMOS Essential |
$2,659.45
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,545.93
|
|
|
PR RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL
|
Professional
|
Both
|
$2,102.94
|
|
|
Service Code
|
HCPCS 27695
|
| Min. Negotiated Rate |
$401.22 |
| Max. Negotiated Rate |
$1,289.63 |
| Rate for Payer: Cash Price |
$576.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$573.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$515.85
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$515.85
|
| Rate for Payer: Fidelis Essential Plan QHP |
$544.51
|
| Rate for Payer: Fidelis Medicare Advantage |
$573.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$544.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$573.17
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$573.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$429.88
|
| Rate for Payer: Healthfirst Commercial |
$573.17
|
| Rate for Payer: Healthfirst Essential Plan |
$1,289.63
|
| Rate for Payer: Healthfirst Medicare Advantage |
$544.51
|
| Rate for Payer: Healthfirst QHP |
$573.17
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$401.22
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$573.17
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$487.19
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$401.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$573.17
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$429.88
|
| Rate for Payer: SOMOS Essential |
$429.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$573.17
|
|
|
PR RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT
|
Professional
|
Both
|
$2,822.68
|
|
|
Service Code
|
HCPCS 27652
|
| Min. Negotiated Rate |
$541.06 |
| Max. Negotiated Rate |
$1,739.12 |
| Rate for Payer: Cash Price |
$783.14
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$772.94
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$695.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$695.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$734.29
|
| Rate for Payer: Fidelis Medicare Advantage |
$772.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$734.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$772.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$772.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$579.71
|
| Rate for Payer: Healthfirst Commercial |
$772.94
|
| Rate for Payer: Healthfirst Essential Plan |
$1,739.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$734.29
|
| Rate for Payer: Healthfirst QHP |
$772.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$541.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$772.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$657.00
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$541.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$772.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$579.71
|
| Rate for Payer: SOMOS Essential |
$579.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$772.94
|
|
|
PR RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL
|
Professional
|
Both
|
$2,995.65
|
|
|
Service Code
|
HCPCS 27405
|
| Min. Negotiated Rate |
$565.29 |
| Max. Negotiated Rate |
$1,817.01 |
| Rate for Payer: Cash Price |
$812.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$807.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$726.80
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$726.80
|
| Rate for Payer: Fidelis Essential Plan QHP |
$767.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$807.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$767.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$807.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$807.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$605.67
|
| Rate for Payer: Healthfirst Commercial |
$807.56
|
| Rate for Payer: Healthfirst Essential Plan |
$1,817.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$767.18
|
| Rate for Payer: Healthfirst QHP |
$807.56
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$565.29
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$807.56
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$686.43
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$565.29
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$807.56
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$605.67
|
| Rate for Payer: SOMOS Essential |
$605.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$807.56
|
|
|
PR RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS
|
Professional
|
Both
|
$2,348.78
|
|
|
Service Code
|
HCPCS 27696
|
| Min. Negotiated Rate |
$446.33 |
| Max. Negotiated Rate |
$1,434.62 |
| Rate for Payer: Cash Price |
$640.57
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$637.61
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$573.85
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$573.85
|
| Rate for Payer: Fidelis Essential Plan QHP |
$605.73
|
| Rate for Payer: Fidelis Medicare Advantage |
$637.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$605.73
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$637.61
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$637.61
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$478.21
|
| Rate for Payer: Healthfirst Commercial |
$637.61
|
| Rate for Payer: Healthfirst Essential Plan |
$1,434.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$605.73
|
| Rate for Payer: Healthfirst QHP |
$637.61
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$446.33
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$637.61
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$541.97
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$446.33
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$637.61
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$478.21
|
| Rate for Payer: SOMOS Essential |
$478.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$637.61
|
|
|
PR RPR PULMONARY ART STENOSIS RCNSTJ W/PATCH/GRAFT
|
Professional
|
Both
|
$6,495.41
|
|
|
Service Code
|
HCPCS 33917
|
| Min. Negotiated Rate |
$1,199.32 |
| Max. Negotiated Rate |
$3,854.95 |
| Rate for Payer: Cash Price |
$1,730.34
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,713.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,541.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,541.98
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,627.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,713.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,627.64
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,713.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,713.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,284.98
|
| Rate for Payer: Healthfirst Commercial |
$1,713.31
|
| Rate for Payer: Healthfirst Essential Plan |
$3,854.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,627.64
|
| Rate for Payer: Healthfirst QHP |
$1,713.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,199.32
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,713.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,456.31
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,199.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,713.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,284.98
|
| Rate for Payer: SOMOS Essential |
$1,284.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,713.31
|
|
|
PR RPR PULMONARY ATRESIA W/CONSTJ/RPLCMT CONDUIT
|
Professional
|
Both
|
$8,057.77
|
|
|
Service Code
|
HCPCS 33920
|
| Min. Negotiated Rate |
$1,481.87 |
| Max. Negotiated Rate |
$4,763.16 |
| Rate for Payer: Cash Price |
$2,138.33
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,116.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,905.26
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,905.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,011.11
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,116.96
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,011.11
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,116.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,116.96
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,587.72
|
| Rate for Payer: Healthfirst Commercial |
$2,116.96
|
| Rate for Payer: Healthfirst Essential Plan |
$4,763.16
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,011.11
|
| Rate for Payer: Healthfirst QHP |
$2,116.96
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,481.87
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,116.96
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,799.42
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,481.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,116.96
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,587.72
|
| Rate for Payer: SOMOS Essential |
$1,587.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,116.96
|
|
|
PR RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL
|
Professional
|
Both
|
$3,546.76
|
|
|
Service Code
|
HCPCS 26548
|
| Min. Negotiated Rate |
$659.81 |
| Max. Negotiated Rate |
$2,120.83 |
| Rate for Payer: Cash Price |
$955.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$942.59
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$848.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$848.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$895.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$942.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$895.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$942.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$942.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$706.94
|
| Rate for Payer: Healthfirst Commercial |
$942.59
|
| Rate for Payer: Healthfirst Essential Plan |
$2,120.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$895.46
|
| Rate for Payer: Healthfirst QHP |
$942.59
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$659.81
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$942.59
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$801.20
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$659.81
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$942.59
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$706.94
|
| Rate for Payer: SOMOS Essential |
$706.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$942.59
|
|
|
PR RPR RECRT FEM HERNIA REDUCIBLE
|
Professional
|
Both
|
$2,744.70
|
|
|
Service Code
|
HCPCS 49555
|
| Min. Negotiated Rate |
$509.99 |
| Max. Negotiated Rate |
$1,639.26 |
| Rate for Payer: Cash Price |
$732.88
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$728.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$655.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$655.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$692.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$728.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$692.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$728.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$728.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$546.42
|
| Rate for Payer: Healthfirst Commercial |
$728.56
|
| Rate for Payer: Healthfirst Essential Plan |
$1,639.26
|
| Rate for Payer: Healthfirst Medicare Advantage |
$692.13
|
| Rate for Payer: Healthfirst QHP |
$728.56
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$509.99
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$728.56
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$619.28
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$509.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$728.56
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$546.42
|
| Rate for Payer: SOMOS Essential |
$546.42
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$728.56
|
|
