|
PR SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$1,005.41
|
|
|
Service Code
|
HCPCS 36245
|
| Min. Negotiated Rate |
$187.45 |
| Max. Negotiated Rate |
$602.50 |
| Rate for Payer: Cash Price |
$269.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$267.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$241.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$241.00
|
| Rate for Payer: Fidelis Essential Plan QHP |
$254.39
|
| Rate for Payer: Fidelis Medicare Advantage |
$267.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$254.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$267.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$267.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$200.84
|
| Rate for Payer: Healthfirst Commercial |
$267.78
|
| Rate for Payer: Healthfirst Essential Plan |
$602.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$254.39
|
| Rate for Payer: Healthfirst QHP |
$267.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$187.45
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$267.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$227.61
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$187.45
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$267.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$200.84
|
| Rate for Payer: SOMOS Essential |
$200.84
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$267.78
|
|
|
PR SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$889.42
|
|
|
Service Code
|
HCPCS 36215
|
| Min. Negotiated Rate |
$168.03 |
| Max. Negotiated Rate |
$540.09 |
| Rate for Payer: Cash Price |
$239.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$240.04
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$216.04
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$216.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$228.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$240.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$228.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$240.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$240.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$180.03
|
| Rate for Payer: Healthfirst Commercial |
$240.04
|
| Rate for Payer: Healthfirst Essential Plan |
$540.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$228.04
|
| Rate for Payer: Healthfirst QHP |
$240.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$168.03
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$240.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$204.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$168.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$240.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$180.03
|
| Rate for Payer: SOMOS Essential |
$180.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$240.04
|
|
|
PR SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH
|
Professional
|
Both
|
$199.57
|
|
|
Service Code
|
HCPCS 36248
|
| Min. Negotiated Rate |
$37.59 |
| Max. Negotiated Rate |
$120.83 |
| Rate for Payer: Cash Price |
$53.34
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$53.70
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$48.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$48.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$51.02
|
| Rate for Payer: Fidelis Medicare Advantage |
$53.70
|
| Rate for Payer: Fidelis Qualified Health Plan |
$51.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$53.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$53.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$40.27
|
| Rate for Payer: Healthfirst Commercial |
$53.70
|
| Rate for Payer: Healthfirst Essential Plan |
$120.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$51.02
|
| Rate for Payer: Healthfirst QHP |
$53.70
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$37.59
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$53.70
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$45.65
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$37.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$53.70
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$40.27
|
| Rate for Payer: SOMOS Essential |
$40.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$53.70
|
|
|
PR SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH
|
Professional
|
Both
|
$224.49
|
|
|
Service Code
|
HCPCS 36218
|
| Min. Negotiated Rate |
$42.41 |
| Max. Negotiated Rate |
$136.31 |
| Rate for Payer: Cash Price |
$60.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$60.58
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$54.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$54.52
|
| Rate for Payer: Fidelis Essential Plan QHP |
$57.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$60.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$57.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$60.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$60.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$45.44
|
| Rate for Payer: Healthfirst Commercial |
$60.58
|
| Rate for Payer: Healthfirst Essential Plan |
$136.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$57.55
|
| Rate for Payer: Healthfirst QHP |
$60.58
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$42.41
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$60.58
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$51.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$42.41
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$60.58
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$45.44
|
| Rate for Payer: SOMOS Essential |
$45.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$60.58
|
|
|
PR SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART
|
Professional
|
Both
|
$706.79
|
|
|
Service Code
|
HCPCS 36015
|
| Min. Negotiated Rate |
$134.76 |
| Max. Negotiated Rate |
$433.15 |
| Rate for Payer: Cash Price |
$190.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$192.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$173.26
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$173.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$182.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$192.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$182.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$192.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$192.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$144.38
|
| Rate for Payer: Healthfirst Commercial |
$192.51
|
| Rate for Payer: Healthfirst Essential Plan |
$433.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$182.88
|
| Rate for Payer: Healthfirst QHP |
$192.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$134.76
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$192.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$163.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$134.76
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$192.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$144.38
|
| Rate for Payer: SOMOS Essential |
$144.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$192.51
|
|
|
PR SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH
|
Professional
|
Both
|
$663.64
|
|
|
Service Code
|
HCPCS 36011
|
| Min. Negotiated Rate |
$123.21 |
| Max. Negotiated Rate |
$396.05 |
| Rate for Payer: Cash Price |
$177.01
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$176.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$158.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$158.42
|
| Rate for Payer: Fidelis Essential Plan QHP |
$167.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$176.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$167.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$176.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$176.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$132.01
|
| Rate for Payer: Healthfirst Commercial |
$176.02
|
| Rate for Payer: Healthfirst Essential Plan |
$396.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$167.22
|
| Rate for Payer: Healthfirst QHP |
$176.02
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$123.21
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$176.02
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$149.62
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$123.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$176.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$132.01
|
| Rate for Payer: SOMOS Essential |
$132.01
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$176.02
|
|
|
PR SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC
|
Professional
|
Both
|
$730.98
|
|
|
Service Code
|
HCPCS 36012
|
| Min. Negotiated Rate |
$138.59 |
| Max. Negotiated Rate |
$445.45 |
| Rate for Payer: Cash Price |
$196.97
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$197.98
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$178.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$178.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$188.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$197.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$188.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$197.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$197.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$148.49
|
| Rate for Payer: Healthfirst Commercial |
$197.98
|
| Rate for Payer: Healthfirst Essential Plan |
$445.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$188.08
|
| Rate for Payer: Healthfirst QHP |
$197.98
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$138.59
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$197.98
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$168.28
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$138.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$197.98
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$148.49
|
| Rate for Payer: SOMOS Essential |
$148.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$197.98
|
|
|
PR SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY
|
Professional
|
Both
|
$1,464.86
|
|
|
Service Code
|
HCPCS 36225
|
| Min. Negotiated Rate |
$274.77 |
| Max. Negotiated Rate |
$883.19 |
| Rate for Payer: Cash Price |
$391.71
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$392.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$353.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$353.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$372.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$392.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$372.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$392.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$392.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$294.40
|
| Rate for Payer: Healthfirst Commercial |
$392.53
|
| Rate for Payer: Healthfirst Essential Plan |
$883.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$372.90
|
| Rate for Payer: Healthfirst QHP |
$392.53
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$274.77
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$392.53
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$333.65
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$274.77
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$392.53
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$294.40
|
| Rate for Payer: SOMOS Essential |
$294.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$392.53
|
|
|
PR SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY
|
Professional
|
Both
|
$1,664.88
|
|
|
Service Code
|
HCPCS 36226
|
| Min. Negotiated Rate |
$309.28 |
| Max. Negotiated Rate |
$994.12 |
| Rate for Payer: Cash Price |
$442.86
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$441.83
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$397.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$397.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$419.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$441.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$419.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$441.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$441.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$331.37
|
| Rate for Payer: Healthfirst Commercial |
$441.83
|
| Rate for Payer: Healthfirst Essential Plan |
$994.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$419.74
|
| Rate for Payer: Healthfirst QHP |
$441.83
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$309.28
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$441.83
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$375.56
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$309.28
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$441.83
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$331.37
|
| Rate for Payer: SOMOS Essential |
$331.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$441.83
|
|
|
PR SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC
|
Professional
|
Both
|
$546.84
|
|
|
Service Code
|
HCPCS 36227
|
| Min. Negotiated Rate |
$101.84 |
| Max. Negotiated Rate |
$327.35 |
| Rate for Payer: Cash Price |
$146.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$145.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$130.94
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$130.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$138.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$145.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$138.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$145.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$145.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$109.12
|
| Rate for Payer: Healthfirst Commercial |
$145.49
|
| Rate for Payer: Healthfirst Essential Plan |
$327.35
|
| Rate for Payer: Healthfirst Medicare Advantage |
$138.22
|
| Rate for Payer: Healthfirst QHP |
$145.49
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$101.84
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$145.49
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$123.67
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$101.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$145.49
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$109.12
|
| Rate for Payer: SOMOS Essential |
$109.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$145.49
|
|
|
PR SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT
|
Professional
|
Both
|
$173.43
|
|
|
Service Code
|
HCPCS 95806 26
|
| Min. Negotiated Rate |
$32.69 |
| Max. Negotiated Rate |
$105.08 |
| Rate for Payer: Cash Price |
$47.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$46.70
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$42.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$42.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$44.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$46.70
|
| Rate for Payer: Fidelis Qualified Health Plan |
$44.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$46.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$46.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$35.02
|
| Rate for Payer: Healthfirst Commercial |
$46.70
|
| Rate for Payer: Healthfirst Essential Plan |
$105.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$44.37
|
| Rate for Payer: Healthfirst QHP |
$46.70
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$32.69
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$46.70
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$39.70
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$32.69
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$46.70
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$35.02
|
| Rate for Payer: SOMOS Essential |
$35.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$46.70
|
|
|
PR SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT
|
Professional
|
Both
|
$211.05
|
|
|
Service Code
|
HCPCS 95806 TC
|
| Min. Negotiated Rate |
$43.53 |
| Max. Negotiated Rate |
$139.91 |
| Rate for Payer: Cash Price |
$60.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$62.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$55.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$55.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$59.07
|
| Rate for Payer: Fidelis Medicare Advantage |
$62.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$59.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$62.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$62.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$46.63
|
| Rate for Payer: Healthfirst Commercial |
$62.18
|
| Rate for Payer: Healthfirst Essential Plan |
$139.91
|
| Rate for Payer: Healthfirst Medicare Advantage |
$59.07
|
| Rate for Payer: Healthfirst QHP |
$62.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$43.53
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$62.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$52.85
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$43.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$62.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$46.63
|
| Rate for Payer: SOMOS Essential |
$46.63
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$62.18
|
|
|
PR SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT
|
Professional
|
Both
|
$384.48
|
|
|
Service Code
|
HCPCS 95806
|
| Min. Negotiated Rate |
$76.22 |
| Max. Negotiated Rate |
$244.98 |
| Rate for Payer: Cash Price |
$108.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$108.88
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$97.99
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$97.99
|
| Rate for Payer: Fidelis Essential Plan QHP |
$103.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$108.88
|
| Rate for Payer: Fidelis Qualified Health Plan |
$103.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$108.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$108.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$81.66
|
| Rate for Payer: Healthfirst Commercial |
$108.88
|
| Rate for Payer: Healthfirst Essential Plan |
$244.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$103.44
|
| Rate for Payer: Healthfirst QHP |
$108.88
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$76.22
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$108.88
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$92.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$76.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$108.88
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$81.66
|
| Rate for Payer: SOMOS Essential |
$81.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$108.88
|
|
|
PR SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN
|
Professional
|
Both
|
$1,654.80
|
|
|
Service Code
|
HCPCS 95807
|
| Min. Negotiated Rate |
$336.13 |
| Max. Negotiated Rate |
$1,080.40 |
| Rate for Payer: Amida Care Medicaid |
$432.25
|
| Rate for Payer: Cash Price |
$481.37
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$480.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$432.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$432.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$456.17
|
| Rate for Payer: Fidelis Medicare Advantage |
$480.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$456.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$480.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$480.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$360.13
|
| Rate for Payer: Healthfirst Commercial |
$480.18
|
| Rate for Payer: Healthfirst Essential Plan |
$1,080.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$456.17
|
| Rate for Payer: Healthfirst QHP |
$480.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$336.13
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$480.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$408.15
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$336.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$480.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$360.13
|
| Rate for Payer: SOMOS Essential |
$360.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$480.18
|
|
|
PR SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN
|
Professional
|
Both
|
$230.20
|
|
|
Service Code
|
HCPCS 95807 26
|
| Min. Negotiated Rate |
$43.74 |
| Max. Negotiated Rate |
$432.25 |
| Rate for Payer: Amida Care Medicaid |
$432.25
|
| Rate for Payer: Cash Price |
$63.88
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$62.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$56.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$56.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$59.36
|
| Rate for Payer: Fidelis Medicare Advantage |
$62.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$59.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$62.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$62.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$46.86
|
| Rate for Payer: Healthfirst Commercial |
$62.48
|
| Rate for Payer: Healthfirst Essential Plan |
$140.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$59.36
|
| Rate for Payer: Healthfirst QHP |
$62.48
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$43.74
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$62.48
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$53.11
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$43.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$62.48
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$46.86
|
| Rate for Payer: SOMOS Essential |
$46.86
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$62.48
|
|
|
PR SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN
|
Professional
|
Both
|
$1,424.61
|
|
|
Service Code
|
HCPCS 95807 TC
|
| Min. Negotiated Rate |
$292.39 |
| Max. Negotiated Rate |
$939.83 |
| Rate for Payer: Amida Care Medicaid |
$432.25
|
| Rate for Payer: Cash Price |
$417.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$417.70
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$375.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$375.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$396.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$417.70
|
| Rate for Payer: Fidelis Qualified Health Plan |
$396.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$417.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$417.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$313.27
|
| Rate for Payer: Healthfirst Commercial |
$417.70
|
| Rate for Payer: Healthfirst Essential Plan |
$939.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$396.81
|
| Rate for Payer: Healthfirst QHP |
$417.70
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$292.39
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$417.70
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$355.05
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$292.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$417.70
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$313.27
|
| Rate for Payer: SOMOS Essential |
$313.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$417.70
|
|
|
PR SLING OPERATION STRESS INCONTINENCE
|
Professional
|
Both
|
$3,206.46
|
|
|
Service Code
|
HCPCS 57288
|
| Min. Negotiated Rate |
$602.74 |
| Max. Negotiated Rate |
$1,937.38 |
| Rate for Payer: Cash Price |
$870.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$861.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$774.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$774.95
|
| Rate for Payer: Fidelis Essential Plan QHP |
$818.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$861.06
|
| Rate for Payer: Fidelis Qualified Health Plan |
$818.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$861.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$861.06
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$645.79
|
| Rate for Payer: Healthfirst Commercial |
$861.06
|
| Rate for Payer: Healthfirst Essential Plan |
$1,937.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$818.01
|
| Rate for Payer: Healthfirst QHP |
$861.06
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$602.74
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$861.06
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$731.90
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$602.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$861.06
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$645.79
|
| Rate for Payer: SOMOS Essential |
$645.79
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$861.06
|
|
|
PR SLING OPRATION CORRJ MALE URINARY INCONTINENCE
|
Professional
|
Both
|
$3,153.43
|
|
|
Service Code
|
HCPCS 53440
|
| Min. Negotiated Rate |
$600.24 |
| Max. Negotiated Rate |
$1,929.33 |
| Rate for Payer: Cash Price |
$862.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$857.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$771.73
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$771.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$814.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$857.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$814.61
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$857.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$857.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$643.11
|
| Rate for Payer: Healthfirst Commercial |
$857.48
|
| Rate for Payer: Healthfirst Essential Plan |
$1,929.33
|
| Rate for Payer: Healthfirst Medicare Advantage |
$814.61
|
| Rate for Payer: Healthfirst QHP |
$857.48
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$600.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$857.48
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$728.86
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$600.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$857.48
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$643.11
|
| Rate for Payer: SOMOS Essential |
$643.11
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$857.48
|
|
|
PR SLITTING PREPUCE DORSAL/LATERAL SPX NEWBORN
|
Professional
|
Both
|
$466.76
|
|
|
Service Code
|
HCPCS 54000
|
| Min. Negotiated Rate |
$90.47 |
| Max. Negotiated Rate |
$290.79 |
| Rate for Payer: Cash Price |
$129.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$129.24
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$116.32
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$116.32
|
| Rate for Payer: Fidelis Essential Plan QHP |
$122.78
|
| Rate for Payer: Fidelis Medicare Advantage |
$129.24
|
| Rate for Payer: Fidelis Qualified Health Plan |
$122.78
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$129.24
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$129.24
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$96.93
|
| Rate for Payer: Healthfirst Commercial |
$129.24
|
| Rate for Payer: Healthfirst Essential Plan |
$290.79
|
| Rate for Payer: Healthfirst Medicare Advantage |
$122.78
|
| Rate for Payer: Healthfirst QHP |
$129.24
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$90.47
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$129.24
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$109.85
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$90.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$129.24
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$96.93
|
| Rate for Payer: SOMOS Essential |
$96.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$129.24
|
|
|
PR SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN
|
Professional
|
Both
|
$591.61
|
|
|
Service Code
|
HCPCS 54001
|
| Min. Negotiated Rate |
$113.68 |
| Max. Negotiated Rate |
$365.40 |
| Rate for Payer: Cash Price |
$162.59
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$162.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$146.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$146.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$154.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$162.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$154.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$162.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$162.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$121.80
|
| Rate for Payer: Healthfirst Commercial |
$162.40
|
| Rate for Payer: Healthfirst Essential Plan |
$365.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$154.28
|
| Rate for Payer: Healthfirst QHP |
$162.40
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$113.68
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$162.40
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$138.04
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$113.68
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$162.40
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$121.80
|
| Rate for Payer: SOMOS Essential |
$121.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$162.40
|
|
|
PR SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME
|
Professional
|
Both
|
$160.55
|
|
|
Service Code
|
HCPCS 95800 26
|
| Min. Negotiated Rate |
$29.13 |
| Max. Negotiated Rate |
$117.08 |
| Rate for Payer: Amida Care Medicaid |
$117.08
|
| Rate for Payer: Cash Price |
$42.52
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$41.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$37.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$37.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$39.54
|
| Rate for Payer: Fidelis Medicare Advantage |
$41.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$39.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$41.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$41.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$31.21
|
| Rate for Payer: Healthfirst Commercial |
$41.62
|
| Rate for Payer: Healthfirst Essential Plan |
$93.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$39.54
|
| Rate for Payer: Healthfirst QHP |
$41.62
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$29.13
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$41.62
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$35.38
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$29.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$41.62
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$31.21
|
| Rate for Payer: SOMOS Essential |
$31.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$41.62
|
|
|
PR SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME
|
Professional
|
Both
|
$471.21
|
|
|
Service Code
|
HCPCS 95800 TC
|
| Min. Negotiated Rate |
$73.68 |
| Max. Negotiated Rate |
$236.84 |
| Rate for Payer: Amida Care Medicaid |
$117.08
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$105.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$94.73
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$94.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$100.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$105.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$100.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$105.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$105.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$78.94
|
| Rate for Payer: Healthfirst Commercial |
$105.26
|
| Rate for Payer: Healthfirst Essential Plan |
$236.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$100.00
|
| Rate for Payer: Healthfirst QHP |
$105.26
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$73.68
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$105.26
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$89.47
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$73.68
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$105.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$78.94
|
| Rate for Payer: SOMOS Essential |
$78.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$105.26
|
|
|
PR SLP STDY UNATND W/HRT RATE/O2 SAT/RESP/SLP TIME
|
Professional
|
Both
|
$631.75
|
|
|
Service Code
|
HCPCS 95800
|
| Min. Negotiated Rate |
$102.82 |
| Max. Negotiated Rate |
$330.48 |
| Rate for Payer: Amida Care Medicaid |
$117.08
|
| Rate for Payer: Cash Price |
$157.72
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$146.88
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$132.19
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$132.19
|
| Rate for Payer: Fidelis Essential Plan QHP |
$139.54
|
| Rate for Payer: Fidelis Medicare Advantage |
$146.88
|
| Rate for Payer: Fidelis Qualified Health Plan |
$139.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$146.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$146.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$110.16
|
| Rate for Payer: Healthfirst Commercial |
$146.88
|
| Rate for Payer: Healthfirst Essential Plan |
$330.48
|
| Rate for Payer: Healthfirst Medicare Advantage |
$139.54
|
| Rate for Payer: Healthfirst QHP |
$146.88
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$102.82
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$146.88
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$124.85
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$102.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$146.88
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$110.16
|
| Rate for Payer: SOMOS Essential |
$110.16
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$146.88
|
|
|
PR SLP STDY UNATND W/MIN HRT RATE/O2 SAT/RESP ANAL
|
Professional
|
Both
|
$160.55
|
|
|
Service Code
|
HCPCS 95801 26
|
| Min. Negotiated Rate |
$30.49 |
| Max. Negotiated Rate |
$98.01 |
| Rate for Payer: Cash Price |
$44.09
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$43.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$39.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$39.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$41.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$43.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$41.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$43.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$43.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$32.67
|
| Rate for Payer: Healthfirst Commercial |
$43.56
|
| Rate for Payer: Healthfirst Essential Plan |
$98.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$41.38
|
| Rate for Payer: Healthfirst QHP |
$43.56
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$30.49
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$43.56
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$37.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$30.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$43.56
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$32.67
|
| Rate for Payer: SOMOS Essential |
$32.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$43.56
|
|
|
PR SLP STDY UNATND W/MIN HRT RATE/O2 SAT/RESP ANAL
|
Professional
|
Both
|
$390.25
|
|
|
Service Code
|
HCPCS 95801
|
| Min. Negotiated Rate |
$77.55 |
| Max. Negotiated Rate |
$249.25 |
| Rate for Payer: Cash Price |
$112.14
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$110.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$99.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$99.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$105.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$110.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$105.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$110.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$110.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$83.08
|
| Rate for Payer: Healthfirst Commercial |
$110.78
|
| Rate for Payer: Healthfirst Essential Plan |
$249.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$105.24
|
| Rate for Payer: Healthfirst QHP |
$110.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$77.55
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$110.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$94.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$77.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$110.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$83.08
|
| Rate for Payer: SOMOS Essential |
$83.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$110.78
|
|
