|
PR TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$2,920.75
|
|
|
Service Code
|
HCPCS 26471
|
| Min. Negotiated Rate |
$544.61 |
| Max. Negotiated Rate |
$1,750.55 |
| Rate for Payer: Cash Price |
$790.02
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$778.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$700.22
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$700.22
|
| Rate for Payer: Fidelis Essential Plan QHP |
$739.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$778.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$739.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$778.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$778.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$583.51
|
| Rate for Payer: Healthfirst Commercial |
$778.02
|
| Rate for Payer: Healthfirst Essential Plan |
$1,750.55
|
| Rate for Payer: Healthfirst Medicare Advantage |
$739.12
|
| Rate for Payer: Healthfirst QHP |
$778.02
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$544.61
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$778.02
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$661.32
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$544.61
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$778.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$583.51
|
| Rate for Payer: SOMOS Essential |
$583.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$778.02
|
|
|
PR TENODESIS WRIST EXTENSORS FINGERS
|
Professional
|
Both
|
$2,846.24
|
|
|
Service Code
|
HCPCS 25301
|
| Min. Negotiated Rate |
$538.20 |
| Max. Negotiated Rate |
$1,729.91 |
| Rate for Payer: Cash Price |
$772.08
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$768.85
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$691.97
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$691.97
|
| Rate for Payer: Fidelis Essential Plan QHP |
$730.41
|
| Rate for Payer: Fidelis Medicare Advantage |
$768.85
|
| Rate for Payer: Fidelis Qualified Health Plan |
$730.41
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$768.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$768.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$576.64
|
| Rate for Payer: Healthfirst Commercial |
$768.85
|
| Rate for Payer: Healthfirst Essential Plan |
$1,729.91
|
| Rate for Payer: Healthfirst Medicare Advantage |
$730.41
|
| Rate for Payer: Healthfirst QHP |
$768.85
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$538.20
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$768.85
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$653.52
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$538.20
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$768.85
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$576.64
|
| Rate for Payer: SOMOS Essential |
$576.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$768.85
|
|
|
PR TENODESIS WRIST FLEXORS FINGERS
|
Professional
|
Both
|
$3,069.68
|
|
|
Service Code
|
HCPCS 25300
|
| Min. Negotiated Rate |
$581.01 |
| Max. Negotiated Rate |
$1,867.52 |
| Rate for Payer: Cash Price |
$831.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$830.01
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$747.01
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$747.01
|
| Rate for Payer: Fidelis Essential Plan QHP |
$788.51
|
| Rate for Payer: Fidelis Medicare Advantage |
$830.01
|
| Rate for Payer: Fidelis Qualified Health Plan |
$788.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$830.01
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$830.01
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$622.51
|
| Rate for Payer: Healthfirst Commercial |
$830.01
|
| Rate for Payer: Healthfirst Essential Plan |
$1,867.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$788.51
|
| Rate for Payer: Healthfirst QHP |
$830.01
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$581.01
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$830.01
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$705.51
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$581.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$830.01
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$622.51
|
| Rate for Payer: SOMOS Essential |
$622.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$830.01
|
|
|
PR TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA
|
Professional
|
Both
|
$3,083.82
|
|
|
Service Code
|
HCPCS 26449
|
| Min. Negotiated Rate |
$587.21 |
| Max. Negotiated Rate |
$1,887.46 |
| Rate for Payer: Cash Price |
$840.61
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$838.87
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$754.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$754.98
|
| Rate for Payer: Fidelis Essential Plan QHP |
$796.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$838.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$796.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$838.87
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$838.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$629.15
|
| Rate for Payer: Healthfirst Commercial |
$838.87
|
| Rate for Payer: Healthfirst Essential Plan |
$1,887.46
|
| Rate for Payer: Healthfirst Medicare Advantage |
$796.93
|
| Rate for Payer: Healthfirst QHP |
$838.87
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$587.21
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$838.87
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$713.04
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$587.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$838.87
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$629.15
|
| Rate for Payer: SOMOS Essential |
$629.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$838.87
|
|
|
PR TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON
|
Professional
|
Both
|
$1,769.29
|
|
|
Service Code
|
HCPCS 28226
|
| Min. Negotiated Rate |
$336.31 |
| Max. Negotiated Rate |
$1,080.99 |
| Rate for Payer: Cash Price |
$482.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$480.44
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$432.40
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$432.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$456.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$480.44
|
| Rate for Payer: Fidelis Qualified Health Plan |
$456.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$480.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$480.44
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$360.33
|
| Rate for Payer: Healthfirst Commercial |
$480.44
|
| Rate for Payer: Healthfirst Essential Plan |
$1,080.99
|
| Rate for Payer: Healthfirst Medicare Advantage |
$456.42
|
| Rate for Payer: Healthfirst QHP |
$480.44
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$336.31
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$480.44
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$408.37
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$336.31
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$480.44
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$360.33
|
| Rate for Payer: SOMOS Essential |
$360.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$480.44
|
|
|
PR TENOLYSIS EXTENSOR FOOT SINGLE TENDON
|
Professional
|
Both
|
$1,114.75
|
|
|
Service Code
|
HCPCS 28225
|
| Min. Negotiated Rate |
$215.63 |
| Max. Negotiated Rate |
$693.09 |
| Rate for Payer: Cash Price |
$308.52
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$308.04
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$277.24
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$277.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$292.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$308.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$292.64
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$308.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$308.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$231.03
|
| Rate for Payer: Healthfirst Commercial |
$308.04
|
| Rate for Payer: Healthfirst Essential Plan |
$693.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$292.64
|
| Rate for Payer: Healthfirst QHP |
$308.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$215.63
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$308.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$261.83
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$215.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$308.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$231.03
|
| Rate for Payer: SOMOS Essential |
$231.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$308.04
|
|
|
PR TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH
|
Professional
|
Both
|
$2,687.83
|
|
|
Service Code
|
HCPCS 26445
|
| Min. Negotiated Rate |
$495.90 |
| Max. Negotiated Rate |
$1,593.97 |
| Rate for Payer: Cash Price |
$721.86
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$708.43
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$637.59
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$637.59
|
| Rate for Payer: Fidelis Essential Plan QHP |
$673.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$708.43
|
| Rate for Payer: Fidelis Qualified Health Plan |
$673.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$708.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$708.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$531.32
|
| Rate for Payer: Healthfirst Commercial |
$708.43
|
| Rate for Payer: Healthfirst Essential Plan |
$1,593.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$673.01
|
| Rate for Payer: Healthfirst QHP |
$708.43
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$495.90
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$708.43
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$602.17
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$495.90
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$708.43
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$531.32
|
| Rate for Payer: SOMOS Essential |
$531.32
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$708.43
|
|
|
PR TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS
|
Professional
|
Both
|
$1,529.89
|
|
|
Service Code
|
HCPCS 28222
|
| Min. Negotiated Rate |
$299.03 |
| Max. Negotiated Rate |
$961.15 |
| Rate for Payer: Cash Price |
$430.31
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$427.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$384.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$384.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$405.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$427.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$405.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$427.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$427.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$320.38
|
| Rate for Payer: Healthfirst Commercial |
$427.18
|
| Rate for Payer: Healthfirst Essential Plan |
$961.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$405.82
|
| Rate for Payer: Healthfirst QHP |
$427.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$299.03
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$427.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$363.10
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$299.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$427.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$320.38
|
| Rate for Payer: SOMOS Essential |
$320.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$427.18
|
|
|
PR TENOLYSIS FLEXOR FOOT SINGLE TENDON
|
Professional
|
Both
|
$1,274.70
|
|
|
Service Code
|
HCPCS 28220
|
| Min. Negotiated Rate |
$246.25 |
| Max. Negotiated Rate |
$791.53 |
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$351.79
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$316.61
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$316.61
|
| Rate for Payer: Fidelis Essential Plan QHP |
$334.20
|
| Rate for Payer: Fidelis Medicare Advantage |
$351.79
|
| Rate for Payer: Fidelis Qualified Health Plan |
$334.20
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$351.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$351.79
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$263.84
|
| Rate for Payer: Healthfirst Commercial |
$351.79
|
| Rate for Payer: Healthfirst Essential Plan |
$791.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$334.20
|
| Rate for Payer: Healthfirst QHP |
$351.79
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$246.25
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$351.79
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$299.02
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$246.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$351.79
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$263.84
|
| Rate for Payer: SOMOS Essential |
$263.84
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$351.79
|
|
|
PR TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO
|
Professional
|
Both
|
$4,370.59
|
|
|
Service Code
|
HCPCS 26442
|
| Min. Negotiated Rate |
$816.85 |
| Max. Negotiated Rate |
$2,625.59 |
| Rate for Payer: Cash Price |
$1,181.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,166.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,050.24
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,050.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,108.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,166.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,108.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,166.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,166.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$875.20
|
| Rate for Payer: Healthfirst Commercial |
$1,166.93
|
| Rate for Payer: Healthfirst Essential Plan |
$2,625.59
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,108.58
|
| Rate for Payer: Healthfirst QHP |
$1,166.93
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$816.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,166.93
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$991.89
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$816.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,166.93
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$875.20
|
| Rate for Payer: SOMOS Essential |
$875.20
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,166.93
|
|
|
PR TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON
|
Professional
|
Both
|
$2,881.48
|
|
|
Service Code
|
HCPCS 26440
|
| Min. Negotiated Rate |
$533.48 |
| Max. Negotiated Rate |
$1,714.77 |
| Rate for Payer: Cash Price |
$776.99
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$762.12
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$685.91
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$685.91
|
| Rate for Payer: Fidelis Essential Plan QHP |
$724.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$762.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$724.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$762.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$762.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$571.59
|
| Rate for Payer: Healthfirst Commercial |
$762.12
|
| Rate for Payer: Healthfirst Essential Plan |
$1,714.77
|
| Rate for Payer: Healthfirst Medicare Advantage |
$724.01
|
| Rate for Payer: Healthfirst QHP |
$762.12
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$533.48
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$762.12
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$647.80
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$533.48
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$762.12
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$571.59
|
| Rate for Payer: SOMOS Essential |
$571.59
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$762.12
|
|
|
PR TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH
|
Professional
|
Both
|
$1,809.82
|
|
|
Service Code
|
HCPCS 27680
|
| Min. Negotiated Rate |
$349.42 |
| Max. Negotiated Rate |
$1,123.13 |
| Rate for Payer: Cash Price |
$497.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$499.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$449.25
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$449.25
|
| Rate for Payer: Fidelis Essential Plan QHP |
$474.21
|
| Rate for Payer: Fidelis Medicare Advantage |
$499.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$474.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$499.17
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$499.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$374.38
|
| Rate for Payer: Healthfirst Commercial |
$499.17
|
| Rate for Payer: Healthfirst Essential Plan |
$1,123.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$474.21
|
| Rate for Payer: Healthfirst QHP |
$499.17
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$349.42
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$499.17
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$424.29
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$349.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$499.17
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$374.38
|
| Rate for Payer: SOMOS Essential |
$374.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$499.17
|
|
|
PR TENOLYSIS TRICEPS
|
Professional
|
Both
|
$2,739.49
|
|
|
Service Code
|
HCPCS 24332
|
| Min. Negotiated Rate |
$519.13 |
| Max. Negotiated Rate |
$1,668.62 |
| Rate for Payer: Cash Price |
$742.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$741.61
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$667.45
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$667.45
|
| Rate for Payer: Fidelis Essential Plan QHP |
$704.53
|
| Rate for Payer: Fidelis Medicare Advantage |
$741.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$704.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$741.61
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$741.61
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$556.21
|
| Rate for Payer: Healthfirst Commercial |
$741.61
|
| Rate for Payer: Healthfirst Essential Plan |
$1,668.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$704.53
|
| Rate for Payer: Healthfirst QHP |
$741.61
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$519.13
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$741.61
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$630.37
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$519.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$741.61
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$556.21
|
| Rate for Payer: SOMOS Essential |
$556.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$741.61
|
|
|
PR TENOPLASTY ELBOW TO SHOULDER SINGLE
|
Professional
|
Both
|
$3,464.48
|
|
|
Service Code
|
HCPCS 24320
|
| Min. Negotiated Rate |
$652.91 |
| Max. Negotiated Rate |
$2,098.64 |
| Rate for Payer: Cash Price |
$935.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$932.73
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$839.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$839.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$886.09
|
| Rate for Payer: Fidelis Medicare Advantage |
$932.73
|
| Rate for Payer: Fidelis Qualified Health Plan |
$886.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$932.73
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$932.73
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$699.55
|
| Rate for Payer: Healthfirst Commercial |
$932.73
|
| Rate for Payer: Healthfirst Essential Plan |
$2,098.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$886.09
|
| Rate for Payer: Healthfirst QHP |
$932.73
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$652.91
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$932.73
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$792.82
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$652.91
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$932.73
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$699.55
|
| Rate for Payer: SOMOS Essential |
$699.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$932.73
|
|
|
PR TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX
|
Professional
|
Both
|
$3,094.53
|
|
|
Service Code
|
HCPCS 27006
|
| Min. Negotiated Rate |
$586.99 |
| Max. Negotiated Rate |
$1,886.74 |
| Rate for Payer: Cash Price |
$844.13
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$838.55
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$754.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$754.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$796.62
|
| Rate for Payer: Fidelis Medicare Advantage |
$838.55
|
| Rate for Payer: Fidelis Qualified Health Plan |
$796.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$838.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$838.55
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$628.91
|
| Rate for Payer: Healthfirst Commercial |
$838.55
|
| Rate for Payer: Healthfirst Essential Plan |
$1,886.74
|
| Rate for Payer: Healthfirst Medicare Advantage |
$796.62
|
| Rate for Payer: Healthfirst QHP |
$838.55
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$586.99
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$838.55
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$712.77
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$586.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$838.55
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$628.91
|
| Rate for Payer: SOMOS Essential |
$628.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$838.55
|
|
|
PR TENOTOMY ADDUCTOR HIP OPEN
|
Professional
|
Both
|
$2,405.20
|
|
|
Service Code
|
HCPCS 27001
|
| Min. Negotiated Rate |
$451.91 |
| Max. Negotiated Rate |
$1,452.56 |
| Rate for Payer: Cash Price |
$649.82
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$645.58
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$581.02
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$581.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$613.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$645.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$613.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$645.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$645.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$484.19
|
| Rate for Payer: Healthfirst Commercial |
$645.58
|
| Rate for Payer: Healthfirst Essential Plan |
$1,452.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$613.30
|
| Rate for Payer: Healthfirst QHP |
$645.58
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$451.91
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$645.58
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$548.74
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$451.91
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$645.58
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$484.19
|
| Rate for Payer: SOMOS Essential |
$484.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$645.58
|
|
|
PR TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX
|
Professional
|
Both
|
$1,672.27
|
|
|
Service Code
|
HCPCS 27000
|
| Min. Negotiated Rate |
$315.83 |
| Max. Negotiated Rate |
$1,015.18 |
| Rate for Payer: Cash Price |
$454.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$451.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$406.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$406.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$428.63
|
| Rate for Payer: Fidelis Medicare Advantage |
$451.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$428.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$451.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$451.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$338.39
|
| Rate for Payer: Healthfirst Commercial |
$451.19
|
| Rate for Payer: Healthfirst Essential Plan |
$1,015.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$428.63
|
| Rate for Payer: Healthfirst QHP |
$451.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$315.83
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$451.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$383.51
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$315.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$451.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$338.39
|
| Rate for Payer: SOMOS Essential |
$338.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$451.19
|
|
|
PR TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS
|
Professional
|
Both
|
$1,801.91
|
|
|
Service Code
|
HCPCS 24357
|
| Min. Negotiated Rate |
$340.32 |
| Max. Negotiated Rate |
$1,093.88 |
| Rate for Payer: Cash Price |
$492.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$486.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$437.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$437.55
|
| Rate for Payer: Fidelis Essential Plan QHP |
$461.86
|
| Rate for Payer: Fidelis Medicare Advantage |
$486.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$461.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$486.17
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$486.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$364.63
|
| Rate for Payer: Healthfirst Commercial |
$486.17
|
| Rate for Payer: Healthfirst Essential Plan |
$1,093.88
|
| Rate for Payer: Healthfirst Medicare Advantage |
$461.86
|
| Rate for Payer: Healthfirst QHP |
$486.17
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$340.32
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$486.17
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$413.24
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$340.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$486.17
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$364.63
|
| Rate for Payer: SOMOS Essential |
$364.63
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$486.17
|
|
|
PR TENOTOMY EXTENSOR HAND/FINGER OPEN EACH TENDON
|
Professional
|
Both
|
$1,990.42
|
|
|
Service Code
|
HCPCS 26460
|
| Min. Negotiated Rate |
$372.58 |
| Max. Negotiated Rate |
$1,197.59 |
| Rate for Payer: Cash Price |
$541.62
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$532.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$479.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$479.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$505.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$532.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$505.65
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$532.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$532.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$399.19
|
| Rate for Payer: Healthfirst Commercial |
$532.26
|
| Rate for Payer: Healthfirst Essential Plan |
$1,197.59
|
| Rate for Payer: Healthfirst Medicare Advantage |
$505.65
|
| Rate for Payer: Healthfirst QHP |
$532.26
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$372.58
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$532.26
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$452.42
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$372.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$532.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$399.19
|
| Rate for Payer: SOMOS Essential |
$399.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$532.26
|
|
|
PR TENOTOMY FLEXOR FINGER OPEN EACH TENDON
|
Professional
|
Both
|
$2,052.40
|
|
|
Service Code
|
HCPCS 26455
|
| Min. Negotiated Rate |
$381.15 |
| Max. Negotiated Rate |
$1,225.12 |
| Rate for Payer: Cash Price |
$553.39
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$544.50
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$490.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$490.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$517.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$544.50
|
| Rate for Payer: Fidelis Qualified Health Plan |
$517.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$544.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$544.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$408.38
|
| Rate for Payer: Healthfirst Commercial |
$544.50
|
| Rate for Payer: Healthfirst Essential Plan |
$1,225.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$517.27
|
| Rate for Payer: Healthfirst QHP |
$544.50
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$381.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$544.50
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$462.82
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$381.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$544.50
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$408.38
|
| Rate for Payer: SOMOS Essential |
$408.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$544.50
|
|
|
PR TENOTOMY FLEXOR PALM OPEN EACH TENDON
|
Professional
|
Both
|
$2,063.32
|
|
|
Service Code
|
HCPCS 26450
|
| Min. Negotiated Rate |
$383.77 |
| Max. Negotiated Rate |
$1,233.56 |
| Rate for Payer: Cash Price |
$556.79
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$548.25
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$493.43
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$493.43
|
| Rate for Payer: Fidelis Essential Plan QHP |
$520.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$548.25
|
| Rate for Payer: Fidelis Qualified Health Plan |
$520.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$548.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$548.25
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$411.19
|
| Rate for Payer: Healthfirst Commercial |
$548.25
|
| Rate for Payer: Healthfirst Essential Plan |
$1,233.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$520.84
|
| Rate for Payer: Healthfirst QHP |
$548.25
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$383.77
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$548.25
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$466.01
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$383.77
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$548.25
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$411.19
|
| Rate for Payer: SOMOS Essential |
$411.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$548.25
|
|
|
PR TENOTOMY HIP FLEXOR OPEN SEPARATE PROCEDURE
|
Professional
|
Both
|
$3,164.88
|
|
|
Service Code
|
HCPCS 27005
|
| Min. Negotiated Rate |
$602.83 |
| Max. Negotiated Rate |
$1,937.65 |
| Rate for Payer: Cash Price |
$861.78
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$861.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$775.06
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$775.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$818.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$861.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$818.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$861.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$861.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$645.88
|
| Rate for Payer: Healthfirst Commercial |
$861.18
|
| Rate for Payer: Healthfirst Essential Plan |
$1,937.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$818.12
|
| Rate for Payer: Healthfirst QHP |
$861.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$602.83
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$861.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$732.00
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$602.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$861.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$645.88
|
| Rate for Payer: SOMOS Essential |
$645.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$861.18
|
|
|
PR TENOTOMY LENGTHENING/RLS ABDUCTOR HALLUCIS MUSC
|
Professional
|
Both
|
$1,232.07
|
|
|
Service Code
|
HCPCS 28240
|
| Min. Negotiated Rate |
$238.14 |
| Max. Negotiated Rate |
$765.45 |
| Rate for Payer: Cash Price |
$340.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$340.20
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$306.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$306.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$323.19
|
| Rate for Payer: Fidelis Medicare Advantage |
$340.20
|
| Rate for Payer: Fidelis Qualified Health Plan |
$323.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$340.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$340.20
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$255.15
|
| Rate for Payer: Healthfirst Commercial |
$340.20
|
| Rate for Payer: Healthfirst Essential Plan |
$765.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$323.19
|
| Rate for Payer: Healthfirst QHP |
$340.20
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$238.14
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$340.20
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$289.17
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$238.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$340.20
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$255.15
|
| Rate for Payer: SOMOS Essential |
$255.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$340.20
|
|
|
PR TENOTOMY OPEN ELBOW TO SHOULDER EACH TENDON
|
Professional
|
Both
|
$2,111.59
|
|
|
Service Code
|
HCPCS 24310
|
| Min. Negotiated Rate |
$394.88 |
| Max. Negotiated Rate |
$1,269.25 |
| Rate for Payer: Cash Price |
$571.58
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$564.11
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$507.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$507.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$535.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$564.11
|
| Rate for Payer: Fidelis Qualified Health Plan |
$535.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$564.11
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$564.11
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$423.08
|
| Rate for Payer: Healthfirst Commercial |
$564.11
|
| Rate for Payer: Healthfirst Essential Plan |
$1,269.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$535.90
|
| Rate for Payer: Healthfirst QHP |
$564.11
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$394.88
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$564.11
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$479.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$394.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$564.11
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$423.08
|
| Rate for Payer: SOMOS Essential |
$423.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$564.11
|
|
|
PR TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON
|
Professional
|
Both
|
$1,131.38
|
|
|
Service Code
|
HCPCS 28234
|
| Min. Negotiated Rate |
$220.49 |
| Max. Negotiated Rate |
$708.73 |
| Rate for Payer: Cash Price |
$314.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$314.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$283.49
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$283.49
|
| Rate for Payer: Fidelis Essential Plan QHP |
$299.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$314.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$299.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$314.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$314.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$236.24
|
| Rate for Payer: Healthfirst Commercial |
$314.99
|
| Rate for Payer: Healthfirst Essential Plan |
$708.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$299.24
|
| Rate for Payer: Healthfirst QHP |
$314.99
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$220.49
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$314.99
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$267.74
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$220.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$314.99
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$236.24
|
| Rate for Payer: SOMOS Essential |
$236.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$314.99
|
|
