|
PR THORACOTOMY W/CARDIAC MASSAGE
|
Professional
|
Both
|
$3,542.18
|
|
|
Service Code
|
HCPCS 32160
|
| Min. Negotiated Rate |
$659.81 |
| Max. Negotiated Rate |
$2,120.83 |
| Rate for Payer: Cash Price |
$945.29
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$942.59
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$848.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$848.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$895.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$942.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$895.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$942.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$942.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$706.94
|
| Rate for Payer: Healthfirst Commercial |
$942.59
|
| Rate for Payer: Healthfirst Essential Plan |
$2,120.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$895.46
|
| Rate for Payer: Healthfirst QHP |
$942.59
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$659.81
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$942.59
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$801.20
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$659.81
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$942.59
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$706.94
|
| Rate for Payer: SOMOS Essential |
$706.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$942.59
|
|
|
PR THORACOTOMY W/DX WEDGE RESEXN & ANTOM LUNG RESE
|
Professional
|
Both
|
$696.36
|
|
|
Service Code
|
HCPCS 32507
|
| Min. Negotiated Rate |
$126.43 |
| Max. Negotiated Rate |
$406.39 |
| Rate for Payer: Cash Price |
$183.30
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$180.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$162.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$162.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$171.59
|
| Rate for Payer: Fidelis Medicare Advantage |
$180.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$171.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$180.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$180.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$135.47
|
| Rate for Payer: Healthfirst Commercial |
$180.62
|
| Rate for Payer: Healthfirst Essential Plan |
$406.39
|
| Rate for Payer: Healthfirst Medicare Advantage |
$171.59
|
| Rate for Payer: Healthfirst QHP |
$180.62
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$126.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$180.62
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$153.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$126.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$180.62
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$135.47
|
| Rate for Payer: SOMOS Essential |
$135.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$180.62
|
|
|
PR THORACOTOMY WITH EXPLORATION
|
Professional
|
Both
|
$3,593.66
|
|
|
Service Code
|
HCPCS 32100
|
| Min. Negotiated Rate |
$669.30 |
| Max. Negotiated Rate |
$2,151.32 |
| Rate for Payer: Cash Price |
$961.13
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$956.14
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$860.53
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$860.53
|
| Rate for Payer: Fidelis Essential Plan QHP |
$908.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$956.14
|
| Rate for Payer: Fidelis Qualified Health Plan |
$908.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$956.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$956.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$717.11
|
| Rate for Payer: Healthfirst Commercial |
$956.14
|
| Rate for Payer: Healthfirst Essential Plan |
$2,151.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$908.33
|
| Rate for Payer: Healthfirst QHP |
$956.14
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$669.30
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$956.14
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$812.72
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$669.30
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$956.14
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$717.11
|
| Rate for Payer: SOMOS Essential |
$717.11
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$956.14
|
|
|
PR THORACOTOMY W/RESECTION BULLAE
|
Professional
|
Both
|
$6,770.86
|
|
|
Service Code
|
HCPCS 32141
|
| Min. Negotiated Rate |
$1,248.55 |
| Max. Negotiated Rate |
$4,013.19 |
| Rate for Payer: Cash Price |
$1,796.92
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,783.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,605.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,605.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,694.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,783.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,694.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,783.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,783.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,337.73
|
| Rate for Payer: Healthfirst Commercial |
$1,783.64
|
| Rate for Payer: Healthfirst Essential Plan |
$4,013.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,694.46
|
| Rate for Payer: Healthfirst QHP |
$1,783.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,248.55
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,783.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,516.09
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,248.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,783.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,337.73
|
| Rate for Payer: SOMOS Essential |
$1,337.73
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,783.64
|
|
|
PR THORACOTOMY W/THERAPEUTIC WEDGE RESEXN INITIAL
|
Professional
|
Both
|
$4,141.80
|
|
|
Service Code
|
HCPCS 32505
|
| Min. Negotiated Rate |
$766.71 |
| Max. Negotiated Rate |
$2,464.43 |
| Rate for Payer: Cash Price |
$1,104.43
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,095.30
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$985.77
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$985.77
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,040.54
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,095.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,040.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,095.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,095.30
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$821.48
|
| Rate for Payer: Healthfirst Commercial |
$1,095.30
|
| Rate for Payer: Healthfirst Essential Plan |
$2,464.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,040.54
|
| Rate for Payer: Healthfirst QHP |
$1,095.30
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$766.71
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,095.30
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$931.00
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$766.71
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,095.30
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$821.48
|
| Rate for Payer: SOMOS Essential |
$821.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,095.30
|
|
|
PR THORACOTOMY W/THERAP WEDGE RESEXN ADDL IPSILATRL
|
Professional
|
Both
|
$696.36
|
|
|
Service Code
|
HCPCS 32506
|
| Min. Negotiated Rate |
$126.43 |
| Max. Negotiated Rate |
$406.39 |
| Rate for Payer: Cash Price |
$183.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$180.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$162.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$162.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$171.59
|
| Rate for Payer: Fidelis Medicare Advantage |
$180.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$171.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$180.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$180.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$135.47
|
| Rate for Payer: Healthfirst Commercial |
$180.62
|
| Rate for Payer: Healthfirst Essential Plan |
$406.39
|
| Rate for Payer: Healthfirst Medicare Advantage |
$171.59
|
| Rate for Payer: Healthfirst QHP |
$180.62
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$126.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$180.62
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$153.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$126.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$180.62
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$135.47
|
| Rate for Payer: SOMOS Essential |
$135.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$180.62
|
|
|
PR THORACTOMY W/DX BX LUNG INFILTRATE UNILATERAL
|
Professional
|
Both
|
$3,553.13
|
|
|
Service Code
|
HCPCS 32096
|
| Min. Negotiated Rate |
$660.49 |
| Max. Negotiated Rate |
$2,123.01 |
| Rate for Payer: Cash Price |
$948.78
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$943.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$849.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$849.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$896.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$943.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$896.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$943.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$943.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$707.67
|
| Rate for Payer: Healthfirst Commercial |
$943.56
|
| Rate for Payer: Healthfirst Essential Plan |
$2,123.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$896.38
|
| Rate for Payer: Healthfirst QHP |
$943.56
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$660.49
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$943.56
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$802.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$660.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$943.56
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$707.67
|
| Rate for Payer: SOMOS Essential |
$707.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$943.56
|
|
|
PR THORACTOMY W/DX BX LUNG NODULE/MASS UNILATERAL
|
Professional
|
Both
|
$3,560.45
|
|
|
Service Code
|
HCPCS 32097
|
| Min. Negotiated Rate |
$661.57 |
| Max. Negotiated Rate |
$2,126.47 |
| Rate for Payer: Cash Price |
$950.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$945.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$850.59
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$850.59
|
| Rate for Payer: Fidelis Essential Plan QHP |
$897.85
|
| Rate for Payer: Fidelis Medicare Advantage |
$945.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$897.85
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$945.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$945.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$708.83
|
| Rate for Payer: Healthfirst Commercial |
$945.10
|
| Rate for Payer: Healthfirst Essential Plan |
$2,126.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$897.85
|
| Rate for Payer: Healthfirst QHP |
$945.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$661.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$945.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$803.34
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$661.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$945.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$708.83
|
| Rate for Payer: SOMOS Essential |
$708.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$945.10
|
|
|
PR THORAX STEREOTACTIC RADIATION TARGET W/TX COURSE
|
Professional
|
Both
|
$914.94
|
|
|
Service Code
|
HCPCS 32701
|
| Min. Negotiated Rate |
$166.56 |
| Max. Negotiated Rate |
$535.37 |
| Rate for Payer: Cash Price |
$241.96
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$237.94
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$214.15
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$214.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$226.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$237.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$226.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$237.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$237.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$178.46
|
| Rate for Payer: Healthfirst Commercial |
$237.94
|
| Rate for Payer: Healthfirst Essential Plan |
$535.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$226.04
|
| Rate for Payer: Healthfirst QHP |
$237.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$166.56
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$237.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$202.25
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$166.56
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$237.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$178.46
|
| Rate for Payer: SOMOS Essential |
$178.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$237.94
|
|
|
PR THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR
|
Professional
|
Both
|
$6,546.89
|
|
|
Service Code
|
HCPCS 32110
|
| Min. Negotiated Rate |
$1,219.25 |
| Max. Negotiated Rate |
$3,919.01 |
| Rate for Payer: Cash Price |
$1,750.30
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,741.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,567.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,567.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,654.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,741.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,654.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,741.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,741.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,306.34
|
| Rate for Payer: Healthfirst Commercial |
$1,741.78
|
| Rate for Payer: Healthfirst Essential Plan |
$3,919.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,654.69
|
| Rate for Payer: Healthfirst QHP |
$1,741.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,219.25
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,741.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,480.51
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,219.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,741.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,306.34
|
| Rate for Payer: SOMOS Essential |
$1,306.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,741.78
|
|
|
PR THORCOM THRC W/MEDSTNL & REGIONAL LMPHADEC
|
Professional
|
Both
|
$949.62
|
|
|
Service Code
|
HCPCS 38746
|
| Min. Negotiated Rate |
$174.69 |
| Max. Negotiated Rate |
$561.49 |
| Rate for Payer: Cash Price |
$252.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$249.55
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$224.59
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$224.59
|
| Rate for Payer: Fidelis Essential Plan QHP |
$237.07
|
| Rate for Payer: Fidelis Medicare Advantage |
$249.55
|
| Rate for Payer: Fidelis Qualified Health Plan |
$237.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$249.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$249.55
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$187.16
|
| Rate for Payer: Healthfirst Commercial |
$249.55
|
| Rate for Payer: Healthfirst Essential Plan |
$561.49
|
| Rate for Payer: Healthfirst Medicare Advantage |
$237.07
|
| Rate for Payer: Healthfirst QHP |
$249.55
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$174.69
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$249.55
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$212.12
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$174.69
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$249.55
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$187.16
|
| Rate for Payer: SOMOS Essential |
$187.16
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$249.55
|
|
|
PR THORCOM W/REMOVAL OF CYST
|
Professional
|
Both
|
$4,410.18
|
|
|
Service Code
|
HCPCS 32140
|
| Min. Negotiated Rate |
$818.10 |
| Max. Negotiated Rate |
$2,629.60 |
| Rate for Payer: Cash Price |
$1,177.65
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,168.71
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,051.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,051.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,110.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,168.71
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,110.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,168.71
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,168.71
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$876.53
|
| Rate for Payer: Healthfirst Commercial |
$1,168.71
|
| Rate for Payer: Healthfirst Essential Plan |
$2,629.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,110.27
|
| Rate for Payer: Healthfirst QHP |
$1,168.71
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$818.10
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,168.71
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$993.40
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$818.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,168.71
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$876.53
|
| Rate for Payer: SOMOS Essential |
$876.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,168.71
|
|
|
PR THORCOM W/RMVL INTRAPLEURAL FB/FIBRIN DEP
|
Professional
|
Both
|
$4,495.44
|
|
|
Service Code
|
HCPCS 32150
|
| Min. Negotiated Rate |
$838.49 |
| Max. Negotiated Rate |
$2,695.14 |
| Rate for Payer: Cash Price |
$1,207.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,197.84
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,078.06
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,078.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,137.95
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,197.84
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,137.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,197.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,197.84
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$898.38
|
| Rate for Payer: Healthfirst Commercial |
$1,197.84
|
| Rate for Payer: Healthfirst Essential Plan |
$2,695.14
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,137.95
|
| Rate for Payer: Healthfirst QHP |
$1,197.84
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$838.49
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,197.84
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,018.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$838.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,197.84
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$898.38
|
| Rate for Payer: SOMOS Essential |
$898.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,197.84
|
|
|
PR THORCOM W/RMVL IPUL FB
|
Professional
|
Both
|
$4,475.87
|
|
|
Service Code
|
HCPCS 32151
|
| Min. Negotiated Rate |
$829.18 |
| Max. Negotiated Rate |
$2,665.24 |
| Rate for Payer: Cash Price |
$1,194.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,184.55
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,066.10
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,066.10
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,125.32
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,184.55
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,125.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,184.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,184.55
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$888.41
|
| Rate for Payer: Healthfirst Commercial |
$1,184.55
|
| Rate for Payer: Healthfirst Essential Plan |
$2,665.24
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,125.32
|
| Rate for Payer: Healthfirst QHP |
$1,184.55
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$829.18
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,184.55
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,006.87
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$829.18
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,184.55
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$888.41
|
| Rate for Payer: SOMOS Essential |
$888.41
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,184.55
|
|
|
PR THORCOSCPY W/MEDIASTINL & REGIONL LYMPHDENECTOMY
|
Professional
|
Both
|
$952.35
|
|
|
Service Code
|
HCPCS 32674
|
| Min. Negotiated Rate |
$175.11 |
| Max. Negotiated Rate |
$562.86 |
| Rate for Payer: Cash Price |
$253.71
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$250.16
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$225.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$225.14
|
| Rate for Payer: Fidelis Essential Plan QHP |
$237.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$250.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$237.65
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$250.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$250.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$187.62
|
| Rate for Payer: Healthfirst Commercial |
$250.16
|
| Rate for Payer: Healthfirst Essential Plan |
$562.86
|
| Rate for Payer: Healthfirst Medicare Advantage |
$237.65
|
| Rate for Payer: Healthfirst QHP |
$250.16
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$175.11
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$250.16
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$212.64
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$175.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$250.16
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$187.62
|
| Rate for Payer: SOMOS Essential |
$187.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$250.16
|
|
|
PR THORSC DX LUNGS/PERICAR/MED/PLEURAL SPACE W/O BX
|
Professional
|
Both
|
$1,365.28
|
|
|
Service Code
|
HCPCS 32601
|
| Min. Negotiated Rate |
$252.19 |
| Max. Negotiated Rate |
$810.61 |
| Rate for Payer: Cash Price |
$363.59
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$360.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$324.24
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$324.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$342.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$360.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$342.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$360.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$360.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$270.20
|
| Rate for Payer: Healthfirst Commercial |
$360.27
|
| Rate for Payer: Healthfirst Essential Plan |
$810.61
|
| Rate for Payer: Healthfirst Medicare Advantage |
$342.26
|
| Rate for Payer: Healthfirst QHP |
$360.27
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$252.19
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$360.27
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$306.23
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$252.19
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$360.27
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$270.20
|
| Rate for Payer: SOMOS Essential |
$270.20
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$360.27
|
|
|
PR THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL
|
Professional
|
Both
|
$2,626.61
|
|
|
Service Code
|
HCPCS 35875
|
| Min. Negotiated Rate |
$481.10 |
| Max. Negotiated Rate |
$1,546.40 |
| Rate for Payer: Cash Price |
$696.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$687.29
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$618.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$618.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$652.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$687.29
|
| Rate for Payer: Fidelis Qualified Health Plan |
$652.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$687.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$687.29
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$515.47
|
| Rate for Payer: Healthfirst Commercial |
$687.29
|
| Rate for Payer: Healthfirst Essential Plan |
$1,546.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$652.93
|
| Rate for Payer: Healthfirst QHP |
$687.29
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$481.10
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$687.29
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$584.20
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$481.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$687.29
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$515.47
|
| Rate for Payer: SOMOS Essential |
$515.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$687.29
|
|
|
PR THRMBC ARTL/VEN GRF XCP HEMO GRF/FSTL W/REVJ GRF
|
Professional
|
Both
|
$4,178.23
|
|
|
Service Code
|
HCPCS 35876
|
| Min. Negotiated Rate |
$766.35 |
| Max. Negotiated Rate |
$2,463.28 |
| Rate for Payer: Cash Price |
$1,108.08
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,094.79
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$985.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$985.31
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,040.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,094.79
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,040.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,094.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,094.79
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$821.09
|
| Rate for Payer: Healthfirst Commercial |
$1,094.79
|
| Rate for Payer: Healthfirst Essential Plan |
$2,463.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,040.05
|
| Rate for Payer: Healthfirst QHP |
$1,094.79
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$766.35
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,094.79
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$930.57
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$766.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,094.79
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$821.09
|
| Rate for Payer: SOMOS Essential |
$821.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,094.79
|
|
|
PR THRMBC DIR/W/CATH AXILL&SUBCLAVIAN VEIN ARM IN
|
Professional
|
Both
|
$2,891.95
|
|
|
Service Code
|
HCPCS 34490
|
| Min. Negotiated Rate |
$470.46 |
| Max. Negotiated Rate |
$1,512.18 |
| Rate for Payer: Cash Price |
$679.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$672.08
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$604.87
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$604.87
|
| Rate for Payer: Fidelis Essential Plan QHP |
$638.48
|
| Rate for Payer: Fidelis Medicare Advantage |
$672.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$638.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$672.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$672.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$504.06
|
| Rate for Payer: Healthfirst Commercial |
$672.08
|
| Rate for Payer: Healthfirst Essential Plan |
$1,512.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$638.48
|
| Rate for Payer: Healthfirst QHP |
$672.08
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$470.46
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$672.08
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$571.27
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$470.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$672.08
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$504.06
|
| Rate for Payer: SOMOS Essential |
$504.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$672.08
|
|
|
PR THRMBC DIR/W/CATH SUBCLAVIAN VEIN NECK INC
|
Professional
|
Both
|
$4,803.93
|
|
|
Service Code
|
HCPCS 34471
|
| Min. Negotiated Rate |
$881.16 |
| Max. Negotiated Rate |
$2,832.30 |
| Rate for Payer: Cash Price |
$1,272.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,258.80
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,132.92
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,132.92
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,195.86
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,258.80
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,195.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,258.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,258.80
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$944.10
|
| Rate for Payer: Healthfirst Commercial |
$1,258.80
|
| Rate for Payer: Healthfirst Essential Plan |
$2,832.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,195.86
|
| Rate for Payer: Healthfirst QHP |
$1,258.80
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$881.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,258.80
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,069.98
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$881.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,258.80
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$944.10
|
| Rate for Payer: SOMOS Essential |
$944.10
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,258.80
|
|
|
PR THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN ABDL&LEG
|
Professional
|
Both
|
$6,389.95
|
|
|
Service Code
|
HCPCS 34451
|
| Min. Negotiated Rate |
$1,171.64 |
| Max. Negotiated Rate |
$3,765.98 |
| Rate for Payer: Cash Price |
$1,692.91
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,673.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,506.39
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,506.39
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,590.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,673.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,590.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,673.77
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,673.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,255.33
|
| Rate for Payer: Healthfirst Commercial |
$1,673.77
|
| Rate for Payer: Healthfirst Essential Plan |
$3,765.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,590.08
|
| Rate for Payer: Healthfirst QHP |
$1,673.77
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,171.64
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,673.77
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,422.70
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,171.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,673.77
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,255.33
|
| Rate for Payer: SOMOS Essential |
$1,255.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,673.77
|
|
|
PR THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN LEG INC
|
Professional
|
Both
|
$3,091.52
|
|
|
Service Code
|
HCPCS 34421
|
| Min. Negotiated Rate |
$568.56 |
| Max. Negotiated Rate |
$1,827.52 |
| Rate for Payer: Cash Price |
$820.79
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$812.23
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$731.01
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$731.01
|
| Rate for Payer: Fidelis Essential Plan QHP |
$771.62
|
| Rate for Payer: Fidelis Medicare Advantage |
$812.23
|
| Rate for Payer: Fidelis Qualified Health Plan |
$771.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$812.23
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$812.23
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$609.17
|
| Rate for Payer: Healthfirst Commercial |
$812.23
|
| Rate for Payer: Healthfirst Essential Plan |
$1,827.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$771.62
|
| Rate for Payer: Healthfirst QHP |
$812.23
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$568.56
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$812.23
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$690.40
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$568.56
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$812.23
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$609.17
|
| Rate for Payer: SOMOS Essential |
$609.17
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$812.23
|
|
|
PR THRMBC DIR/W/CATH VENA CAVA ILIAC VEIN ABDL INC
|
Professional
|
Both
|
$6,526.07
|
|
|
Service Code
|
HCPCS 34401
|
| Min. Negotiated Rate |
$1,093.51 |
| Max. Negotiated Rate |
$3,514.86 |
| Rate for Payer: Cash Price |
$1,749.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,562.16
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,405.94
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,405.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,484.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,562.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,484.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,562.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,562.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,171.62
|
| Rate for Payer: Healthfirst Commercial |
$1,562.16
|
| Rate for Payer: Healthfirst Essential Plan |
$3,514.86
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,484.05
|
| Rate for Payer: Healthfirst QHP |
$1,562.16
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,093.51
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,562.16
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,327.84
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,093.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,562.16
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,171.62
|
| Rate for Payer: SOMOS Essential |
$1,171.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,562.16
|
|
|
PR THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF
|
Professional
|
Both
|
$2,737.91
|
|
|
Service Code
|
HCPCS 36831
|
| Min. Negotiated Rate |
$505.11 |
| Max. Negotiated Rate |
$1,623.58 |
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$721.59
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$649.43
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$649.43
|
| Rate for Payer: Fidelis Essential Plan QHP |
$685.51
|
| Rate for Payer: Fidelis Medicare Advantage |
$721.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$685.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$721.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$721.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$541.19
|
| Rate for Payer: Healthfirst Commercial |
$721.59
|
| Rate for Payer: Healthfirst Essential Plan |
$1,623.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$685.51
|
| Rate for Payer: Healthfirst QHP |
$721.59
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$505.11
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$721.59
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$613.35
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$505.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$721.59
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$541.19
|
| Rate for Payer: SOMOS Essential |
$541.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$721.59
|
|
|
PR THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX
|
Professional
|
Both
|
$1,652.88
|
|
|
Service Code
|
HCPCS 37211
|
| Min. Negotiated Rate |
$307.55 |
| Max. Negotiated Rate |
$988.56 |
| Rate for Payer: Cash Price |
$443.19
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$439.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$395.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$395.42
|
| Rate for Payer: Fidelis Essential Plan QHP |
$417.39
|
| Rate for Payer: Fidelis Medicare Advantage |
$439.36
|
| Rate for Payer: Fidelis Qualified Health Plan |
$417.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$439.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$439.36
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$329.52
|
| Rate for Payer: Healthfirst Commercial |
$439.36
|
| Rate for Payer: Healthfirst Essential Plan |
$988.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$417.39
|
| Rate for Payer: Healthfirst QHP |
$439.36
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$307.55
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$439.36
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$373.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$307.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$439.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$329.52
|
| Rate for Payer: SOMOS Essential |
$329.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$439.36
|
|
