|
CHG INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I
|
Professional
|
Both
|
$105.88
|
|
|
Service Code
|
HCPCS 74340 26
|
| Min. Negotiated Rate |
$19.48 |
| Max. Negotiated Rate |
$62.62 |
| Rate for Payer: Cash Price |
$27.78
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$27.83
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$25.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$25.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$26.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$27.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$26.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$27.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$27.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20.87
|
| Rate for Payer: Healthfirst Commercial |
$27.83
|
| Rate for Payer: Healthfirst Essential Plan |
$62.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$26.44
|
| Rate for Payer: Healthfirst QHP |
$27.83
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$19.48
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$27.83
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$23.66
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$19.48
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$27.83
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$20.87
|
| Rate for Payer: SOMOS Essential |
$20.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$27.83
|
|
|
CHG JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS
|
Professional
|
Both
|
$66.92
|
|
|
Service Code
|
HCPCS 77077 26
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$40.59 |
| Rate for Payer: Cash Price |
$18.26
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$18.04
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$16.24
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$16.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$17.14
|
| Rate for Payer: Fidelis Medicare Advantage |
$18.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$17.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$13.53
|
| Rate for Payer: Healthfirst Commercial |
$18.04
|
| Rate for Payer: Healthfirst Essential Plan |
$40.59
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17.14
|
| Rate for Payer: Healthfirst QHP |
$18.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$12.63
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$18.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$15.33
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$12.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$18.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$13.53
|
| Rate for Payer: SOMOS Essential |
$13.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$18.04
|
|
|
CHG JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS
|
Professional
|
Both
|
$133.56
|
|
|
Service Code
|
HCPCS 77077 TC
|
| Min. Negotiated Rate |
$24.61 |
| Max. Negotiated Rate |
$79.11 |
| Rate for Payer: Cash Price |
$36.38
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$35.16
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$31.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$31.64
|
| Rate for Payer: Fidelis Essential Plan QHP |
$33.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$35.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$33.40
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$35.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$35.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26.37
|
| Rate for Payer: Healthfirst Commercial |
$35.16
|
| Rate for Payer: Healthfirst Essential Plan |
$79.11
|
| Rate for Payer: Healthfirst Medicare Advantage |
$33.40
|
| Rate for Payer: Healthfirst QHP |
$35.16
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$24.61
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$35.16
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$29.89
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$24.61
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$35.16
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26.37
|
| Rate for Payer: SOMOS Essential |
$26.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$35.16
|
|
|
CHG JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS
|
Professional
|
Both
|
$200.48
|
|
|
Service Code
|
HCPCS 77077
|
| Min. Negotiated Rate |
$37.24 |
| Max. Negotiated Rate |
$119.70 |
| Rate for Payer: Cash Price |
$54.64
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$53.20
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$47.88
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$47.88
|
| Rate for Payer: Fidelis Essential Plan QHP |
$50.54
|
| Rate for Payer: Fidelis Medicare Advantage |
$53.20
|
| Rate for Payer: Fidelis Qualified Health Plan |
$50.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$53.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$53.20
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$39.90
|
| Rate for Payer: Healthfirst Commercial |
$53.20
|
| Rate for Payer: Healthfirst Essential Plan |
$119.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$50.54
|
| Rate for Payer: Healthfirst QHP |
$53.20
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$37.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$53.20
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$45.22
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$37.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$53.20
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$39.90
|
| Rate for Payer: SOMOS Essential |
$39.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$53.20
|
|
|
CHG KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY
|
Professional
|
Both
|
$485.35
|
|
|
Service Code
|
HCPCS 78725
|
| Min. Negotiated Rate |
$78.98 |
| Max. Negotiated Rate |
$253.87 |
| Rate for Payer: Cash Price |
$113.43
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$112.83
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$101.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$101.55
|
| Rate for Payer: Fidelis Essential Plan QHP |
$107.19
|
| Rate for Payer: Fidelis Medicare Advantage |
$112.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$107.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$112.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$112.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$84.62
|
| Rate for Payer: Healthfirst Commercial |
$112.83
|
| Rate for Payer: Healthfirst Essential Plan |
$253.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$107.19
|
| Rate for Payer: Healthfirst QHP |
$112.83
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$78.98
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$112.83
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$95.91
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$78.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$112.83
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$84.62
|
| Rate for Payer: SOMOS Essential |
$84.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$112.83
|
|
|
CHG KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY
|
Professional
|
Both
|
$69.02
|
|
|
Service Code
|
HCPCS 78725 26
|
| Min. Negotiated Rate |
$12.59 |
| Max. Negotiated Rate |
$40.45 |
| Rate for Payer: Cash Price |
$18.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$17.98
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$16.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$16.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$17.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$17.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$17.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$17.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$13.48
|
| Rate for Payer: Healthfirst Commercial |
$17.98
|
| Rate for Payer: Healthfirst Essential Plan |
$40.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17.08
|
| Rate for Payer: Healthfirst QHP |
$17.98
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$12.59
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$17.98
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$15.28
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$12.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17.98
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$13.48
|
| Rate for Payer: SOMOS Essential |
$13.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17.98
|
|
|
CHG KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY
|
Professional
|
Both
|
$416.33
|
|
|
Service Code
|
HCPCS 78725 TC
|
| Min. Negotiated Rate |
$66.39 |
| Max. Negotiated Rate |
$213.41 |
| Rate for Payer: Cash Price |
$95.23
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$94.85
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$85.36
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$85.36
|
| Rate for Payer: Fidelis Essential Plan QHP |
$90.11
|
| Rate for Payer: Fidelis Medicare Advantage |
$94.85
|
| Rate for Payer: Fidelis Qualified Health Plan |
$90.11
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$94.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$94.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$71.14
|
| Rate for Payer: Healthfirst Commercial |
$94.85
|
| Rate for Payer: Healthfirst Essential Plan |
$213.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$90.11
|
| Rate for Payer: Healthfirst QHP |
$94.85
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$66.39
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$94.85
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$80.62
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$66.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$94.85
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$71.14
|
| Rate for Payer: SOMOS Essential |
$71.14
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$94.85
|
|
|
CHG KIDNEY IMAGING MORPHOLOGY
|
Professional
|
Both
|
$690.90
|
|
|
Service Code
|
HCPCS 78700
|
| Min. Negotiated Rate |
$127.30 |
| Max. Negotiated Rate |
$409.16 |
| Rate for Payer: Cash Price |
$186.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$181.85
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$163.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$163.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$172.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$181.85
|
| Rate for Payer: Fidelis Qualified Health Plan |
$172.76
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$181.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$181.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$136.39
|
| Rate for Payer: Healthfirst Commercial |
$181.85
|
| Rate for Payer: Healthfirst Essential Plan |
$409.16
|
| Rate for Payer: Healthfirst Medicare Advantage |
$172.76
|
| Rate for Payer: Healthfirst QHP |
$181.85
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$127.30
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$181.85
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$154.57
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$127.30
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$181.85
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$136.39
|
| Rate for Payer: SOMOS Essential |
$136.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$181.85
|
|
|
CHG KIDNEY IMAGING MORPHOLOGY
|
Professional
|
Both
|
$607.50
|
|
|
Service Code
|
HCPCS 78700 TC
|
| Min. Negotiated Rate |
$111.50 |
| Max. Negotiated Rate |
$358.40 |
| Rate for Payer: Cash Price |
$163.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$159.29
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$143.36
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$143.36
|
| Rate for Payer: Fidelis Essential Plan QHP |
$151.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$159.29
|
| Rate for Payer: Fidelis Qualified Health Plan |
$151.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$159.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$159.29
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$119.47
|
| Rate for Payer: Healthfirst Commercial |
$159.29
|
| Rate for Payer: Healthfirst Essential Plan |
$358.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$151.33
|
| Rate for Payer: Healthfirst QHP |
$159.29
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$111.50
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$159.29
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$135.40
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$111.50
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$159.29
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$119.47
|
| Rate for Payer: SOMOS Essential |
$119.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$159.29
|
|
|
CHG KIDNEY IMAGING MORPHOLOGY
|
Professional
|
Both
|
$83.41
|
|
|
Service Code
|
HCPCS 78700 26
|
| Min. Negotiated Rate |
$15.79 |
| Max. Negotiated Rate |
$50.76 |
| Rate for Payer: Cash Price |
$22.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$22.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$20.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$21.43
|
| Rate for Payer: Fidelis Medicare Advantage |
$22.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$22.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.92
|
| Rate for Payer: Healthfirst Commercial |
$22.56
|
| Rate for Payer: Healthfirst Essential Plan |
$50.76
|
| Rate for Payer: Healthfirst Medicare Advantage |
$21.43
|
| Rate for Payer: Healthfirst QHP |
$22.56
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$15.79
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$22.56
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$19.18
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$15.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$22.56
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$16.92
|
| Rate for Payer: SOMOS Essential |
$16.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$22.56
|
|
|
CHG KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW
|
Professional
|
Both
|
$92.72
|
|
|
Service Code
|
HCPCS 78701 26
|
| Min. Negotiated Rate |
$17.57 |
| Max. Negotiated Rate |
$56.48 |
| Rate for Payer: Cash Price |
$25.02
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$25.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22.59
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$22.59
|
| Rate for Payer: Fidelis Essential Plan QHP |
$23.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$25.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$25.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18.82
|
| Rate for Payer: Healthfirst Commercial |
$25.10
|
| Rate for Payer: Healthfirst Essential Plan |
$56.48
|
| Rate for Payer: Healthfirst Medicare Advantage |
$23.84
|
| Rate for Payer: Healthfirst QHP |
$25.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$17.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$25.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$21.34
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$17.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$25.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18.82
|
| Rate for Payer: SOMOS Essential |
$18.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$25.10
|
|
|
CHG KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW
|
Professional
|
Both
|
$907.24
|
|
|
Service Code
|
HCPCS 78701
|
| Min. Negotiated Rate |
$166.84 |
| Max. Negotiated Rate |
$536.29 |
| Rate for Payer: Cash Price |
$244.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$238.35
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$214.51
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$214.51
|
| Rate for Payer: Fidelis Essential Plan QHP |
$226.43
|
| Rate for Payer: Fidelis Medicare Advantage |
$238.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$226.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$238.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$238.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$178.76
|
| Rate for Payer: Healthfirst Commercial |
$238.35
|
| Rate for Payer: Healthfirst Essential Plan |
$536.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$226.43
|
| Rate for Payer: Healthfirst QHP |
$238.35
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$166.84
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$238.35
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$202.60
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$166.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$238.35
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$178.76
|
| Rate for Payer: SOMOS Essential |
$178.76
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$238.35
|
|
|
CHG KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW
|
Professional
|
Both
|
$814.52
|
|
|
Service Code
|
HCPCS 78701 TC
|
| Min. Negotiated Rate |
$149.27 |
| Max. Negotiated Rate |
$479.79 |
| Rate for Payer: Cash Price |
$219.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$213.24
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$191.92
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$191.92
|
| Rate for Payer: Fidelis Essential Plan QHP |
$202.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$213.24
|
| Rate for Payer: Fidelis Qualified Health Plan |
$202.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$213.24
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$213.24
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$159.93
|
| Rate for Payer: Healthfirst Commercial |
$213.24
|
| Rate for Payer: Healthfirst Essential Plan |
$479.79
|
| Rate for Payer: Healthfirst Medicare Advantage |
$202.58
|
| Rate for Payer: Healthfirst QHP |
$213.24
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$149.27
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$213.24
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$181.25
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$149.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$213.24
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$159.93
|
| Rate for Payer: SOMOS Essential |
$159.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$213.24
|
|
|
CHG KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX
|
Professional
|
Both
|
$757.02
|
|
|
Service Code
|
HCPCS 78707 TC
|
| Min. Negotiated Rate |
$138.13 |
| Max. Negotiated Rate |
$443.99 |
| Rate for Payer: Cash Price |
$203.29
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$197.33
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$177.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$177.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$187.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$197.33
|
| Rate for Payer: Fidelis Qualified Health Plan |
$187.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$197.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$197.33
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$148.00
|
| Rate for Payer: Healthfirst Commercial |
$197.33
|
| Rate for Payer: Healthfirst Essential Plan |
$443.99
|
| Rate for Payer: Healthfirst Medicare Advantage |
$187.46
|
| Rate for Payer: Healthfirst QHP |
$197.33
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$138.13
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$197.33
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$167.73
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$138.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$197.33
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$148.00
|
| Rate for Payer: SOMOS Essential |
$148.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$197.33
|
|
|
CHG KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX
|
Professional
|
Both
|
$175.74
|
|
|
Service Code
|
HCPCS 78707 26
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$107.06 |
| Rate for Payer: Cash Price |
$47.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$47.58
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$42.82
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$42.82
|
| Rate for Payer: Fidelis Essential Plan QHP |
$45.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$47.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$45.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$47.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$47.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$35.69
|
| Rate for Payer: Healthfirst Commercial |
$47.58
|
| Rate for Payer: Healthfirst Essential Plan |
$107.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$45.20
|
| Rate for Payer: Healthfirst QHP |
$47.58
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$33.31
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$47.58
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$40.44
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$33.31
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$47.58
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$35.69
|
| Rate for Payer: SOMOS Essential |
$35.69
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$47.58
|
|
|
CHG KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX
|
Professional
|
Both
|
$932.75
|
|
|
Service Code
|
HCPCS 78707
|
| Min. Negotiated Rate |
$171.43 |
| Max. Negotiated Rate |
$551.02 |
| Rate for Payer: Cash Price |
$251.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$244.90
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$220.41
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$220.41
|
| Rate for Payer: Fidelis Essential Plan QHP |
$232.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$244.90
|
| Rate for Payer: Fidelis Qualified Health Plan |
$232.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$244.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$244.90
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$183.68
|
| Rate for Payer: Healthfirst Commercial |
$244.90
|
| Rate for Payer: Healthfirst Essential Plan |
$551.02
|
| Rate for Payer: Healthfirst Medicare Advantage |
$232.66
|
| Rate for Payer: Healthfirst QHP |
$244.90
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$171.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$244.90
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$208.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$171.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$244.90
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$183.68
|
| Rate for Payer: SOMOS Essential |
$183.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$244.90
|
|
|
CHG KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX
|
Professional
|
Both
|
$220.01
|
|
|
Service Code
|
HCPCS 78708 26
|
| Min. Negotiated Rate |
$42.21 |
| Max. Negotiated Rate |
$135.68 |
| Rate for Payer: Cash Price |
$60.65
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$60.30
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$54.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$54.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$57.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$60.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$57.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$60.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$60.30
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$45.23
|
| Rate for Payer: Healthfirst Commercial |
$60.30
|
| Rate for Payer: Healthfirst Essential Plan |
$135.68
|
| Rate for Payer: Healthfirst Medicare Advantage |
$57.28
|
| Rate for Payer: Healthfirst QHP |
$60.30
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$42.21
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$60.30
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$51.26
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$42.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$60.30
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$45.23
|
| Rate for Payer: SOMOS Essential |
$45.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$60.30
|
|
|
CHG KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX
|
Professional
|
Both
|
$515.52
|
|
|
Service Code
|
HCPCS 78708 TC
|
| Min. Negotiated Rate |
$98.73 |
| Max. Negotiated Rate |
$317.34 |
| Rate for Payer: Cash Price |
$142.62
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$141.04
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$126.94
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$126.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$133.99
|
| Rate for Payer: Fidelis Medicare Advantage |
$141.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$133.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$141.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$141.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$105.78
|
| Rate for Payer: Healthfirst Commercial |
$141.04
|
| Rate for Payer: Healthfirst Essential Plan |
$317.34
|
| Rate for Payer: Healthfirst Medicare Advantage |
$133.99
|
| Rate for Payer: Healthfirst QHP |
$141.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$98.73
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$141.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$119.88
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$98.73
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$141.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$105.78
|
| Rate for Payer: SOMOS Essential |
$105.78
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$141.04
|
|
|
CHG KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX
|
Professional
|
Both
|
$735.49
|
|
|
Service Code
|
HCPCS 78708
|
| Min. Negotiated Rate |
$140.94 |
| Max. Negotiated Rate |
$453.04 |
| Rate for Payer: Cash Price |
$203.27
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$201.35
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$181.22
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$181.22
|
| Rate for Payer: Fidelis Essential Plan QHP |
$191.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$201.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$191.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$201.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$201.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$151.01
|
| Rate for Payer: Healthfirst Commercial |
$201.35
|
| Rate for Payer: Healthfirst Essential Plan |
$453.04
|
| Rate for Payer: Healthfirst Medicare Advantage |
$191.28
|
| Rate for Payer: Healthfirst QHP |
$201.35
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$140.94
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$201.35
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$171.15
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$140.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$201.35
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$151.01
|
| Rate for Payer: SOMOS Essential |
$151.01
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$201.35
|
|
|
CHG KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE
|
Professional
|
Both
|
$1,215.31
|
|
|
Service Code
|
HCPCS 78709 TC
|
| Min. Negotiated Rate |
$218.72 |
| Max. Negotiated Rate |
$703.01 |
| Rate for Payer: Cash Price |
$323.99
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$312.45
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$281.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$281.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$296.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$312.45
|
| Rate for Payer: Fidelis Qualified Health Plan |
$296.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$312.45
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$312.45
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$234.34
|
| Rate for Payer: Healthfirst Commercial |
$312.45
|
| Rate for Payer: Healthfirst Essential Plan |
$703.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$296.83
|
| Rate for Payer: Healthfirst QHP |
$312.45
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$218.72
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$312.45
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$265.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$218.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$312.45
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$234.34
|
| Rate for Payer: SOMOS Essential |
$234.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$312.45
|
|
|
CHG KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE
|
Professional
|
Both
|
$1,475.88
|
|
|
Service Code
|
HCPCS 78709
|
| Min. Negotiated Rate |
$267.38 |
| Max. Negotiated Rate |
$859.43 |
| Rate for Payer: Cash Price |
$394.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$381.97
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$343.77
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$343.77
|
| Rate for Payer: Fidelis Essential Plan QHP |
$362.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$381.97
|
| Rate for Payer: Fidelis Qualified Health Plan |
$362.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$381.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$381.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$286.48
|
| Rate for Payer: Healthfirst Commercial |
$381.97
|
| Rate for Payer: Healthfirst Essential Plan |
$859.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$362.87
|
| Rate for Payer: Healthfirst QHP |
$381.97
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$267.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$381.97
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$324.67
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$267.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$381.97
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$286.48
|
| Rate for Payer: SOMOS Essential |
$286.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$381.97
|
|
|
CHG KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE
|
Professional
|
Both
|
$260.58
|
|
|
Service Code
|
HCPCS 78709 26
|
| Min. Negotiated Rate |
$48.66 |
| Max. Negotiated Rate |
$156.42 |
| Rate for Payer: Cash Price |
$70.61
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$69.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$62.57
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$62.57
|
| Rate for Payer: Fidelis Essential Plan QHP |
$66.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$69.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$66.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$69.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$69.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$52.14
|
| Rate for Payer: Healthfirst Commercial |
$69.52
|
| Rate for Payer: Healthfirst Essential Plan |
$156.42
|
| Rate for Payer: Healthfirst Medicare Advantage |
$66.04
|
| Rate for Payer: Healthfirst QHP |
$69.52
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$48.66
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$69.52
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$59.09
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$48.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$69.52
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$52.14
|
| Rate for Payer: SOMOS Essential |
$52.14
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$69.52
|
|
|
CHG LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE
|
Professional
|
Both
|
$463.82
|
|
|
Service Code
|
HCPCS 78140
|
| Min. Negotiated Rate |
$88.06 |
| Max. Negotiated Rate |
$283.05 |
| Rate for Payer: Cash Price |
$127.58
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$125.80
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$113.22
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$113.22
|
| Rate for Payer: Fidelis Essential Plan QHP |
$119.51
|
| Rate for Payer: Fidelis Medicare Advantage |
$125.80
|
| Rate for Payer: Fidelis Qualified Health Plan |
$119.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$125.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$125.80
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$94.35
|
| Rate for Payer: Healthfirst Commercial |
$125.80
|
| Rate for Payer: Healthfirst Essential Plan |
$283.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$119.51
|
| Rate for Payer: Healthfirst QHP |
$125.80
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$88.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$125.80
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$106.93
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$88.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$125.80
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$94.35
|
| Rate for Payer: SOMOS Essential |
$94.35
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$125.80
|
|
|
CHG LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE
|
Professional
|
Both
|
$93.52
|
|
|
Service Code
|
HCPCS 78140 26
|
| Min. Negotiated Rate |
$17.86 |
| Max. Negotiated Rate |
$57.40 |
| Rate for Payer: Cash Price |
$25.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$25.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$22.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$24.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$25.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$25.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19.13
|
| Rate for Payer: Healthfirst Commercial |
$25.51
|
| Rate for Payer: Healthfirst Essential Plan |
$57.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$24.23
|
| Rate for Payer: Healthfirst QHP |
$25.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$17.86
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$25.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$21.68
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$17.86
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$25.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19.13
|
| Rate for Payer: SOMOS Essential |
$19.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$25.51
|
|
|
CHG LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE
|
Professional
|
Both
|
$370.34
|
|
|
Service Code
|
HCPCS 78140 TC
|
| Min. Negotiated Rate |
$70.20 |
| Max. Negotiated Rate |
$225.65 |
| Rate for Payer: Cash Price |
$101.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$100.29
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$90.26
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$90.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$95.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$100.29
|
| Rate for Payer: Fidelis Qualified Health Plan |
$95.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$100.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$100.29
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$75.22
|
| Rate for Payer: Healthfirst Commercial |
$100.29
|
| Rate for Payer: Healthfirst Essential Plan |
$225.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$95.28
|
| Rate for Payer: Healthfirst QHP |
$100.29
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$70.20
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$100.29
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$85.25
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$70.20
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$100.29
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$75.22
|
| Rate for Payer: SOMOS Essential |
$75.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$100.29
|
|
