|
PR THERAPEUTIC PROPHYLACTIC/DX NJX INTRA-ARTERIAL
|
Professional
|
Both
|
$75.78
|
|
|
Service Code
|
HCPCS 96373
|
| Min. Negotiated Rate |
$15.13 |
| Max. Negotiated Rate |
$48.62 |
| Rate for Payer: Cash Price |
$21.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$21.61
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$19.45
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$19.45
|
| Rate for Payer: Fidelis Essential Plan QHP |
$20.53
|
| Rate for Payer: Fidelis Medicare Advantage |
$21.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$20.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.61
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21.61
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.21
|
| Rate for Payer: Healthfirst Commercial |
$21.61
|
| Rate for Payer: Healthfirst Essential Plan |
$48.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$20.53
|
| Rate for Payer: Healthfirst QHP |
$21.61
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$15.13
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$21.61
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$18.37
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$15.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$21.61
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$16.21
|
| Rate for Payer: SOMOS Essential |
$16.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21.61
|
|
|
PR THERAPEUTIC PX 1/> AREAS EACH 15 MIN EXERCISES
|
Professional
|
Both
|
$119.46
|
|
|
Service Code
|
HCPCS 97110
|
| Min. Negotiated Rate |
$22.97 |
| Max. Negotiated Rate |
$73.82 |
| Rate for Payer: Cash Price |
$32.82
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$32.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$29.53
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$29.53
|
| Rate for Payer: Fidelis Essential Plan QHP |
$31.17
|
| Rate for Payer: Fidelis Medicare Advantage |
$32.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$31.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$32.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$32.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24.61
|
| Rate for Payer: Healthfirst Commercial |
$32.81
|
| Rate for Payer: Healthfirst Essential Plan |
$73.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$31.17
|
| Rate for Payer: Healthfirst QHP |
$32.81
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$22.97
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$32.81
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$27.89
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$22.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$32.81
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24.61
|
| Rate for Payer: SOMOS Essential |
$24.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$32.81
|
|
|
PR THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT
|
Professional
|
Both
|
$473.24
|
|
|
Service Code
|
HCPCS 62329
|
| Min. Negotiated Rate |
$82.96 |
| Max. Negotiated Rate |
$266.67 |
| Rate for Payer: Cash Price |
$119.43
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$118.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$106.67
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$106.67
|
| Rate for Payer: Fidelis Essential Plan QHP |
$112.59
|
| Rate for Payer: Fidelis Medicare Advantage |
$118.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$112.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$118.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$118.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$88.89
|
| Rate for Payer: Healthfirst Commercial |
$118.52
|
| Rate for Payer: Healthfirst Essential Plan |
$266.67
|
| Rate for Payer: Healthfirst Medicare Advantage |
$112.59
|
| Rate for Payer: Healthfirst QHP |
$118.52
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$82.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$118.52
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$100.74
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$82.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$118.52
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$88.89
|
| Rate for Payer: SOMOS Essential |
$88.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$118.52
|
|
|
PR THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF
|
Professional
|
Both
|
$414.75
|
|
|
Service Code
|
HCPCS 62272
|
| Min. Negotiated Rate |
$79.57 |
| Max. Negotiated Rate |
$255.76 |
| Rate for Payer: Cash Price |
$111.78
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$113.67
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$102.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$102.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$107.99
|
| Rate for Payer: Fidelis Medicare Advantage |
$113.67
|
| Rate for Payer: Fidelis Qualified Health Plan |
$107.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$113.67
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$113.67
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$85.25
|
| Rate for Payer: Healthfirst Commercial |
$113.67
|
| Rate for Payer: Healthfirst Essential Plan |
$255.76
|
| Rate for Payer: Healthfirst Medicare Advantage |
$107.99
|
| Rate for Payer: Healthfirst QHP |
$113.67
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$79.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$113.67
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$96.62
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$79.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$113.67
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$85.25
|
| Rate for Payer: SOMOS Essential |
$85.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$113.67
|
|
|
PR THER APHERESIS W/EXTRACORPOREAL IMMUNOADSORPTION
|
Professional
|
Both
|
$370.90
|
|
|
Service Code
|
HCPCS 36516
|
| Min. Negotiated Rate |
$72.53 |
| Max. Negotiated Rate |
$233.15 |
| Rate for Payer: Cash Price |
$100.13
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$103.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$93.26
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$93.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$98.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$103.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$98.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$103.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$103.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$77.72
|
| Rate for Payer: Healthfirst Commercial |
$103.62
|
| Rate for Payer: Healthfirst Essential Plan |
$233.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$98.44
|
| Rate for Payer: Healthfirst QHP |
$103.62
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$72.53
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$103.62
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$88.08
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$72.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$103.62
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$77.72
|
| Rate for Payer: SOMOS Essential |
$77.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$103.62
|
|
|
PR THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG
|
Professional
|
Both
|
$774.94
|
|
|
Service Code
|
HCPCS 90868
|
| Min. Negotiated Rate |
$177.13 |
| Max. Negotiated Rate |
$177.13 |
| Rate for Payer: Amida Care Medicaid |
$177.13
|
|
|
PR THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES
|
Professional
|
Both
|
$86.91
|
|
|
Service Code
|
HCPCS 97129
|
| Min. Negotiated Rate |
$16.57 |
| Max. Negotiated Rate |
$53.26 |
| Rate for Payer: Cash Price |
$23.96
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$23.67
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$21.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$22.49
|
| Rate for Payer: Fidelis Medicare Advantage |
$23.67
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22.49
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23.67
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$23.67
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.75
|
| Rate for Payer: Healthfirst Commercial |
$23.67
|
| Rate for Payer: Healthfirst Essential Plan |
$53.26
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22.49
|
| Rate for Payer: Healthfirst QHP |
$23.67
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$16.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$23.67
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$20.12
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$16.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$23.67
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$17.75
|
| Rate for Payer: SOMOS Essential |
$17.75
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$23.67
|
|
|
PR THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES
|
Professional
|
Both
|
$84.42
|
|
|
Service Code
|
HCPCS 97130
|
| Min. Negotiated Rate |
$16.09 |
| Max. Negotiated Rate |
$51.70 |
| Rate for Payer: Cash Price |
$22.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$22.98
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20.68
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$20.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$21.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$22.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$22.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.23
|
| Rate for Payer: Healthfirst Commercial |
$22.98
|
| Rate for Payer: Healthfirst Essential Plan |
$51.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$21.83
|
| Rate for Payer: Healthfirst QHP |
$22.98
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$16.09
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$22.98
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$19.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$16.09
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$22.98
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$17.23
|
| Rate for Payer: SOMOS Essential |
$17.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$22.98
|
|
|
PR THERMAL DSTRJ INTRAOSSEOUS BVN 1ST 2 LMBR/SAC
|
Professional
|
Both
|
$2,037.42
|
|
|
Service Code
|
HCPCS 64628
|
| Min. Negotiated Rate |
$326.15 |
| Max. Negotiated Rate |
$1,048.34 |
| Rate for Payer: Cash Price |
$475.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$465.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$419.34
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$419.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$442.63
|
| Rate for Payer: Fidelis Medicare Advantage |
$465.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$442.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$465.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$465.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$349.45
|
| Rate for Payer: Healthfirst Commercial |
$465.93
|
| Rate for Payer: Healthfirst Essential Plan |
$1,048.34
|
| Rate for Payer: Healthfirst Medicare Advantage |
$442.63
|
| Rate for Payer: Healthfirst QHP |
$465.93
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$326.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$465.93
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$396.04
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$326.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$465.93
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$349.45
|
| Rate for Payer: SOMOS Essential |
$349.45
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$465.93
|
|
|
PR THERMAL DSTRJ INTRAOSSEOUS BVN EA ADDL LMBR/SAC
|
Professional
|
Both
|
$949.13
|
|
|
Service Code
|
HCPCS 64629
|
| Min. Negotiated Rate |
$153.53 |
| Max. Negotiated Rate |
$493.49 |
| Rate for Payer: Cash Price |
$224.84
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$219.33
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$197.40
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$197.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$208.36
|
| Rate for Payer: Fidelis Medicare Advantage |
$219.33
|
| Rate for Payer: Fidelis Qualified Health Plan |
$208.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$219.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$219.33
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$164.50
|
| Rate for Payer: Healthfirst Commercial |
$219.33
|
| Rate for Payer: Healthfirst Essential Plan |
$493.49
|
| Rate for Payer: Healthfirst Medicare Advantage |
$208.36
|
| Rate for Payer: Healthfirst QHP |
$219.33
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$153.53
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$219.33
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$186.43
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$153.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$219.33
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$164.50
|
| Rate for Payer: SOMOS Essential |
$164.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$219.33
|
|
|
PR THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG
|
Professional
|
Both
|
$158.83
|
|
|
Service Code
|
HCPCS 96374
|
| Min. Negotiated Rate |
$28.30 |
| Max. Negotiated Rate |
$90.97 |
| Rate for Payer: Cash Price |
$42.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$40.43
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36.39
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$36.39
|
| Rate for Payer: Fidelis Essential Plan QHP |
$38.41
|
| Rate for Payer: Fidelis Medicare Advantage |
$40.43
|
| Rate for Payer: Fidelis Qualified Health Plan |
$38.41
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$40.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30.32
|
| Rate for Payer: Healthfirst Commercial |
$40.43
|
| Rate for Payer: Healthfirst Essential Plan |
$90.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$38.41
|
| Rate for Payer: Healthfirst QHP |
$40.43
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$28.30
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$40.43
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$34.37
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$28.30
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$40.43
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$30.32
|
| Rate for Payer: SOMOS Essential |
$30.32
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$40.43
|
|
|
PR THER PX 1/> AREAS EA 15 MIN GAIT TRAING W/STAIR
|
Professional
|
Both
|
$119.46
|
|
|
Service Code
|
HCPCS 97116
|
| Min. Negotiated Rate |
$22.97 |
| Max. Negotiated Rate |
$73.82 |
| Rate for Payer: Cash Price |
$32.82
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$32.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$29.53
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$29.53
|
| Rate for Payer: Fidelis Essential Plan QHP |
$31.17
|
| Rate for Payer: Fidelis Medicare Advantage |
$32.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$31.17
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$32.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$32.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24.61
|
| Rate for Payer: Healthfirst Commercial |
$32.81
|
| Rate for Payer: Healthfirst Essential Plan |
$73.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$31.17
|
| Rate for Payer: Healthfirst QHP |
$32.81
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$22.97
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$32.81
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$27.89
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$22.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$32.81
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24.61
|
| Rate for Payer: SOMOS Essential |
$24.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$32.81
|
|
|
PR THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS
|
Professional
|
Both
|
$150.54
|
|
|
Service Code
|
HCPCS 97113
|
| Min. Negotiated Rate |
$29.40 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Cash Price |
$41.33
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$42.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$37.80
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$37.80
|
| Rate for Payer: Fidelis Essential Plan QHP |
$39.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$42.00
|
| Rate for Payer: Fidelis Qualified Health Plan |
$39.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$42.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$42.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$31.50
|
| Rate for Payer: Healthfirst Commercial |
$42.00
|
| Rate for Payer: Healthfirst Essential Plan |
$94.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$39.90
|
| Rate for Payer: Healthfirst QHP |
$42.00
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$29.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$42.00
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$35.70
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$29.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$42.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$31.50
|
| Rate for Payer: SOMOS Essential |
$31.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$42.00
|
|
|
PR THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA
|
Professional
|
Both
|
$137.24
|
|
|
Service Code
|
HCPCS 97112
|
| Min. Negotiated Rate |
$25.53 |
| Max. Negotiated Rate |
$82.06 |
| Rate for Payer: Cash Price |
$37.71
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$36.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$32.82
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$32.82
|
| Rate for Payer: Fidelis Essential Plan QHP |
$34.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$36.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$34.65
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$36.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$36.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$27.35
|
| Rate for Payer: Healthfirst Commercial |
$36.47
|
| Rate for Payer: Healthfirst Essential Plan |
$82.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$34.65
|
| Rate for Payer: Healthfirst QHP |
$36.47
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$25.53
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$36.47
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$31.00
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$25.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$36.47
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$27.35
|
| Rate for Payer: SOMOS Essential |
$27.35
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$36.47
|
|
|
PR THER PX 1/> AREAS EACH 15 MINUTES MASSAGE
|
Professional
|
Both
|
$124.18
|
|
|
Service Code
|
HCPCS 97124
|
| Min. Negotiated Rate |
$24.09 |
| Max. Negotiated Rate |
$77.42 |
| Rate for Payer: Cash Price |
$34.44
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$34.41
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$30.97
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$30.97
|
| Rate for Payer: Fidelis Essential Plan QHP |
$32.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$34.41
|
| Rate for Payer: Fidelis Qualified Health Plan |
$32.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34.41
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$34.41
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25.81
|
| Rate for Payer: Healthfirst Commercial |
$34.41
|
| Rate for Payer: Healthfirst Essential Plan |
$77.42
|
| Rate for Payer: Healthfirst Medicare Advantage |
$32.69
|
| Rate for Payer: Healthfirst QHP |
$34.41
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$24.09
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$34.41
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$29.25
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$24.09
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$34.41
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$25.81
|
| Rate for Payer: SOMOS Essential |
$25.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$34.41
|
|
|
PR THER SP-GENRATJ DEV PRGRMG&MODIFICAJ
|
Professional
|
Both
|
$420.18
|
|
|
Service Code
|
HCPCS 92609
|
| Min. Negotiated Rate |
$42.60 |
| Max. Negotiated Rate |
$259.83 |
| Rate for Payer: Amida Care Medicaid |
$42.60
|
| Rate for Payer: Cash Price |
$116.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$115.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$103.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$103.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$109.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$115.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$109.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$115.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$115.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$86.61
|
| Rate for Payer: Healthfirst Commercial |
$115.48
|
| Rate for Payer: Healthfirst Essential Plan |
$259.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$109.71
|
| Rate for Payer: Healthfirst QHP |
$115.48
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$80.84
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$115.48
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$98.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$80.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$115.48
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$86.61
|
| Rate for Payer: SOMOS Essential |
$86.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$115.48
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING
|
Professional
|
Both
|
$445.41
|
|
|
Service Code
|
HCPCS 32555
|
| Min. Negotiated Rate |
$83.66 |
| Max. Negotiated Rate |
$268.92 |
| Rate for Payer: Cash Price |
$120.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$119.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$107.57
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$107.57
|
| Rate for Payer: Fidelis Essential Plan QHP |
$113.54
|
| Rate for Payer: Fidelis Medicare Advantage |
$119.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$113.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$119.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$119.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$89.64
|
| Rate for Payer: Healthfirst Commercial |
$119.52
|
| Rate for Payer: Healthfirst Essential Plan |
$268.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$113.54
|
| Rate for Payer: Healthfirst QHP |
$119.52
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$83.66
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$119.52
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$101.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$83.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$119.52
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$89.64
|
| Rate for Payer: SOMOS Essential |
$89.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$119.52
|
|
|
PR THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING
|
Professional
|
Both
|
$366.07
|
|
|
Service Code
|
HCPCS 32554
|
| Min. Negotiated Rate |
$68.73 |
| Max. Negotiated Rate |
$220.93 |
| Rate for Payer: Cash Price |
$99.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$98.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$88.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$88.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$93.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$98.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$93.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$98.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$98.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$73.64
|
| Rate for Payer: Healthfirst Commercial |
$98.19
|
| Rate for Payer: Healthfirst Essential Plan |
$220.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$93.28
|
| Rate for Payer: Healthfirst QHP |
$98.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$68.73
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$98.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$83.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$68.73
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$98.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$73.64
|
| Rate for Payer: SOMOS Essential |
$73.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$98.19
|
|
|
PR THORACOPLASTY SCHEDE TYPE/EXTRAPLEURAL
|
Professional
|
Both
|
$5,941.43
|
|
|
Service Code
|
HCPCS 32905
|
| Min. Negotiated Rate |
$1,096.93 |
| Max. Negotiated Rate |
$3,525.84 |
| Rate for Payer: Cash Price |
$1,582.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,567.04
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,410.34
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,410.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,488.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,567.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,488.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,567.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,567.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,175.28
|
| Rate for Payer: Healthfirst Commercial |
$1,567.04
|
| Rate for Payer: Healthfirst Essential Plan |
$3,525.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,488.69
|
| Rate for Payer: Healthfirst QHP |
$1,567.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,096.93
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,567.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,331.98
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,096.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,567.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,175.28
|
| Rate for Payer: SOMOS Essential |
$1,175.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,567.04
|
|
|
PR THORACOP SCHEDE TYP/XTRPLEURAL CLSR BRNCPLR FSTL
|
Professional
|
Both
|
$7,335.13
|
|
|
Service Code
|
HCPCS 32906
|
| Min. Negotiated Rate |
$1,351.38 |
| Max. Negotiated Rate |
$4,343.72 |
| Rate for Payer: Cash Price |
$1,951.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,930.54
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,737.49
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,737.49
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,834.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,930.54
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,834.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,930.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,930.54
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,447.90
|
| Rate for Payer: Healthfirst Commercial |
$1,930.54
|
| Rate for Payer: Healthfirst Essential Plan |
$4,343.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,834.01
|
| Rate for Payer: Healthfirst QHP |
$1,930.54
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,351.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,930.54
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,640.96
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,351.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,930.54
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,447.90
|
| Rate for Payer: SOMOS Essential |
$1,447.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,930.54
|
|
|
PR THORACOSCOPY CONTROL TRAUMATIC HEMORRHAGE
|
Professional
|
Both
|
$5,204.29
|
|
|
Service Code
|
HCPCS 32654
|
| Min. Negotiated Rate |
$984.42 |
| Max. Negotiated Rate |
$3,164.22 |
| Rate for Payer: Cash Price |
$1,395.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,406.32
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,265.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,265.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,336.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,406.32
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,336.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,406.32
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,406.32
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,054.74
|
| Rate for Payer: Healthfirst Commercial |
$1,406.32
|
| Rate for Payer: Healthfirst Essential Plan |
$3,164.22
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,336.00
|
| Rate for Payer: Healthfirst QHP |
$1,406.32
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$984.42
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,406.32
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,195.37
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$984.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,406.32
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,054.74
|
| Rate for Payer: SOMOS Essential |
$1,054.74
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,406.32
|
|
|
PR THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX
|
Professional
|
Both
|
$2,049.43
|
|
|
Service Code
|
HCPCS 32606
|
| Min. Negotiated Rate |
$378.62 |
| Max. Negotiated Rate |
$1,217.00 |
| Rate for Payer: Cash Price |
$544.86
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$540.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$486.80
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$486.80
|
| Rate for Payer: Fidelis Essential Plan QHP |
$513.85
|
| Rate for Payer: Fidelis Medicare Advantage |
$540.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$513.85
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$540.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$540.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$405.67
|
| Rate for Payer: Healthfirst Commercial |
$540.89
|
| Rate for Payer: Healthfirst Essential Plan |
$1,217.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$513.85
|
| Rate for Payer: Healthfirst QHP |
$540.89
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$378.62
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$540.89
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$459.76
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$378.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$540.89
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$405.67
|
| Rate for Payer: SOMOS Essential |
$405.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$540.89
|
|
|
PR THORACOSCOPY DX PERICARDIAL SAC W/BIOPSY SPX
|
Professional
|
Both
|
$2,128.70
|
|
|
Service Code
|
HCPCS 32604
|
| Min. Negotiated Rate |
$392.11 |
| Max. Negotiated Rate |
$1,260.36 |
| Rate for Payer: Cash Price |
$566.18
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$560.16
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$504.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$504.14
|
| Rate for Payer: Fidelis Essential Plan QHP |
$532.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$560.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$532.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$560.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$560.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$420.12
|
| Rate for Payer: Healthfirst Commercial |
$560.16
|
| Rate for Payer: Healthfirst Essential Plan |
$1,260.36
|
| Rate for Payer: Healthfirst Medicare Advantage |
$532.15
|
| Rate for Payer: Healthfirst QHP |
$560.16
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$392.11
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$560.16
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$476.14
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$392.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$560.16
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$420.12
|
| Rate for Payer: SOMOS Essential |
$420.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$560.16
|
|
|
PR THORACOSCOPY RESEXN THYMUS UNI/BILATERAL
|
Professional
|
Both
|
$5,406.56
|
|
|
Service Code
|
HCPCS 32673
|
| Min. Negotiated Rate |
$997.95 |
| Max. Negotiated Rate |
$3,207.69 |
| Rate for Payer: Cash Price |
$1,439.62
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,425.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,283.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,283.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,354.36
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,425.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,354.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,425.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,425.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,069.23
|
| Rate for Payer: Healthfirst Commercial |
$1,425.64
|
| Rate for Payer: Healthfirst Essential Plan |
$3,207.69
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,354.36
|
| Rate for Payer: Healthfirst QHP |
$1,425.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$997.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,425.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,211.79
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$997.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,425.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,069.23
|
| Rate for Payer: SOMOS Essential |
$1,069.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,425.64
|
|
|
PR THORACOSCOPY RMVL INTRAPLEURAL FB/FIBRIN DEPOSIT
|
Professional
|
Both
|
$4,694.13
|
|
|
Service Code
|
HCPCS 32653
|
| Min. Negotiated Rate |
$869.32 |
| Max. Negotiated Rate |
$2,794.25 |
| Rate for Payer: Cash Price |
$1,249.84
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,241.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,117.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,117.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,179.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,241.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,179.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,241.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,241.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$931.42
|
| Rate for Payer: Healthfirst Commercial |
$1,241.89
|
| Rate for Payer: Healthfirst Essential Plan |
$2,794.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,179.80
|
| Rate for Payer: Healthfirst QHP |
$1,241.89
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$869.32
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,241.89
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,055.61
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$869.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,241.89
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$931.42
|
| Rate for Payer: SOMOS Essential |
$931.42
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,241.89
|
|
