|
PR THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX
|
Professional
|
Both
|
$980.70
|
|
|
Service Code
|
HCPCS 37213
|
| Min. Negotiated Rate |
$182.52 |
| Max. Negotiated Rate |
$586.66 |
| Rate for Payer: Cash Price |
$261.91
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$260.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$234.67
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$234.67
|
| Rate for Payer: Fidelis Essential Plan QHP |
$247.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$260.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$247.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$260.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$260.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$195.56
|
| Rate for Payer: Healthfirst Commercial |
$260.74
|
| Rate for Payer: Healthfirst Essential Plan |
$586.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$247.70
|
| Rate for Payer: Healthfirst QHP |
$260.74
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$182.52
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$260.74
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$221.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$182.52
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$260.74
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$195.56
|
| Rate for Payer: SOMOS Essential |
$195.56
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$260.74
|
|
|
PR THROMBOLYSIS CORONARY INTRAVENOUS INFUSION
|
Professional
|
Both
|
$242.73
|
|
|
Service Code
|
HCPCS 92977
|
| Min. Negotiated Rate |
$48.06 |
| Max. Negotiated Rate |
$154.49 |
| Rate for Payer: Amida Care Medicaid |
$110.00
|
| Rate for Payer: Cash Price |
$68.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$68.66
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$61.79
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$61.79
|
| Rate for Payer: Fidelis Essential Plan QHP |
$65.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$68.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$65.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$68.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$68.66
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$51.49
|
| Rate for Payer: Healthfirst Commercial |
$68.66
|
| Rate for Payer: Healthfirst Essential Plan |
$154.49
|
| Rate for Payer: Healthfirst Medicare Advantage |
$65.23
|
| Rate for Payer: Healthfirst QHP |
$68.66
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$48.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$68.66
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$58.36
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$48.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$68.66
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$51.49
|
| Rate for Payer: SOMOS Essential |
$51.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$68.66
|
|
|
PR THROMBOLYSIS INTRACORONARY NFS SLCTV ANGRPH
|
Professional
|
Both
|
$1,648.64
|
|
|
Service Code
|
HCPCS 92975
|
| Min. Negotiated Rate |
$202.87 |
| Max. Negotiated Rate |
$974.81 |
| Rate for Payer: Amida Care Medicaid |
$202.87
|
| Rate for Payer: Cash Price |
$438.02
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$433.25
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$389.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$389.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$411.59
|
| Rate for Payer: Fidelis Medicare Advantage |
$433.25
|
| Rate for Payer: Fidelis Qualified Health Plan |
$411.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$433.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$433.25
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$324.94
|
| Rate for Payer: Healthfirst Commercial |
$433.25
|
| Rate for Payer: Healthfirst Essential Plan |
$974.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$411.59
|
| Rate for Payer: Healthfirst QHP |
$433.25
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$303.27
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$433.25
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$368.26
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$303.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$433.25
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$324.94
|
| Rate for Payer: SOMOS Essential |
$324.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$433.25
|
|
|
PR THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX
|
Professional
|
Both
|
$1,433.81
|
|
|
Service Code
|
HCPCS 37212
|
| Min. Negotiated Rate |
$266.74 |
| Max. Negotiated Rate |
$857.38 |
| Rate for Payer: Cash Price |
$383.62
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$381.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$342.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$342.95
|
| Rate for Payer: Fidelis Essential Plan QHP |
$362.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$381.06
|
| Rate for Payer: Fidelis Qualified Health Plan |
$362.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$381.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$381.06
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$285.80
|
| Rate for Payer: Healthfirst Commercial |
$381.06
|
| Rate for Payer: Healthfirst Essential Plan |
$857.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$362.01
|
| Rate for Payer: Healthfirst QHP |
$381.06
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$266.74
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$381.06
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$323.90
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$266.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$381.06
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$285.80
|
| Rate for Payer: SOMOS Essential |
$285.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$381.06
|
|
|
PR THRSC CRTJ PRCRD WINDOW/PRTL RESCJ PRCRD SAC
|
Professional
|
Both
|
$3,262.98
|
|
|
Service Code
|
HCPCS 32659
|
| Min. Negotiated Rate |
$606.16 |
| Max. Negotiated Rate |
$1,948.37 |
| Rate for Payer: Cash Price |
$872.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$865.94
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$779.35
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$779.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$822.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$865.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$822.64
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$865.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$865.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$649.46
|
| Rate for Payer: Healthfirst Commercial |
$865.94
|
| Rate for Payer: Healthfirst Essential Plan |
$1,948.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$822.64
|
| Rate for Payer: Healthfirst QHP |
$865.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$606.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$865.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$736.05
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$606.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$865.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$649.46
|
| Rate for Payer: SOMOS Essential |
$649.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$865.94
|
|
|
PR THRSC TOT PULM DCRTCTJ INTRAPLEURAL PNEUMONOLSS
|
Professional
|
Both
|
$7,393.12
|
|
|
Service Code
|
HCPCS 32652
|
| Min. Negotiated Rate |
$1,363.66 |
| Max. Negotiated Rate |
$4,383.20 |
| Rate for Payer: Cash Price |
$1,967.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,948.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,753.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,753.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,850.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,948.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,850.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,948.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,948.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,461.07
|
| Rate for Payer: Healthfirst Commercial |
$1,948.09
|
| Rate for Payer: Healthfirst Essential Plan |
$4,383.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,850.69
|
| Rate for Payer: Healthfirst QHP |
$1,948.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,363.66
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,948.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,655.88
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,363.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,948.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,461.07
|
| Rate for Payer: SOMOS Essential |
$1,461.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,948.09
|
|
|
PR THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX
|
Professional
|
Both
|
$6,080.62
|
|
|
Service Code
|
HCPCS 60522
|
| Min. Negotiated Rate |
$1,124.40 |
| Max. Negotiated Rate |
$3,614.13 |
| Rate for Payer: Cash Price |
$1,619.64
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,606.28
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,445.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,445.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,525.97
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,606.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,525.97
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,606.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,606.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,204.71
|
| Rate for Payer: Healthfirst Commercial |
$1,606.28
|
| Rate for Payer: Healthfirst Essential Plan |
$3,614.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,525.97
|
| Rate for Payer: Healthfirst QHP |
$1,606.28
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,124.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,606.28
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,365.34
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,124.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,606.28
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,204.71
|
| Rate for Payer: SOMOS Essential |
$1,204.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,606.28
|
|
|
PR THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX
|
Professional
|
Both
|
$4,705.79
|
|
|
Service Code
|
HCPCS 60520
|
| Min. Negotiated Rate |
$874.17 |
| Max. Negotiated Rate |
$2,809.82 |
| Rate for Payer: Cash Price |
$1,258.81
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,248.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,123.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,123.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,186.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,248.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,186.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,248.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,248.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$936.61
|
| Rate for Payer: Healthfirst Commercial |
$1,248.81
|
| Rate for Payer: Healthfirst Essential Plan |
$2,809.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,186.37
|
| Rate for Payer: Healthfirst QHP |
$1,248.81
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$874.17
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,248.81
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,061.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$874.17
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,248.81
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$936.61
|
| Rate for Payer: SOMOS Essential |
$936.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,248.81
|
|
|
PR THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX
|
Professional
|
Both
|
$5,015.85
|
|
|
Service Code
|
HCPCS 60521
|
| Min. Negotiated Rate |
$928.87 |
| Max. Negotiated Rate |
$2,985.64 |
| Rate for Payer: Cash Price |
$1,336.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,326.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,194.26
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,194.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,260.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,326.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,260.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,326.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,326.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$995.21
|
| Rate for Payer: Healthfirst Commercial |
$1,326.95
|
| Rate for Payer: Healthfirst Essential Plan |
$2,985.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,260.60
|
| Rate for Payer: Healthfirst QHP |
$1,326.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$928.87
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,326.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,127.91
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$928.87
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,326.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$995.21
|
| Rate for Payer: SOMOS Essential |
$995.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,326.95
|
|
|
PR THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL
|
Professional
|
Both
|
$4,784.19
|
|
|
Service Code
|
HCPCS 60260
|
| Min. Negotiated Rate |
$890.78 |
| Max. Negotiated Rate |
$2,863.22 |
| Rate for Payer: Cash Price |
$1,284.56
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,272.54
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,145.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,145.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,208.91
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,272.54
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,208.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,272.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,272.54
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$954.40
|
| Rate for Payer: Healthfirst Commercial |
$1,272.54
|
| Rate for Payer: Healthfirst Essential Plan |
$2,863.22
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,208.91
|
| Rate for Payer: Healthfirst QHP |
$1,272.54
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$890.78
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,272.54
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,081.66
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$890.78
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,272.54
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$954.40
|
| Rate for Payer: SOMOS Essential |
$954.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,272.54
|
|
|
PR THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH
|
Professional
|
Both
|
$4,648.39
|
|
|
Service Code
|
HCPCS 60271
|
| Min. Negotiated Rate |
$866.38 |
| Max. Negotiated Rate |
$2,784.78 |
| Rate for Payer: Cash Price |
$1,247.63
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,237.68
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,113.91
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,113.91
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,175.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,237.68
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,175.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,237.68
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,237.68
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$928.26
|
| Rate for Payer: Healthfirst Commercial |
$1,237.68
|
| Rate for Payer: Healthfirst Essential Plan |
$2,784.78
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,175.80
|
| Rate for Payer: Healthfirst QHP |
$1,237.68
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$866.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,237.68
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,052.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$866.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,237.68
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$928.26
|
| Rate for Payer: SOMOS Essential |
$928.26
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,237.68
|
|
|
PR THYROIDECTOMY TOTAL/COMPLETE
|
Professional
|
Both
|
$4,056.12
|
|
|
Service Code
|
HCPCS 60240
|
| Min. Negotiated Rate |
$755.12 |
| Max. Negotiated Rate |
$2,427.19 |
| Rate for Payer: Cash Price |
$1,088.62
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,078.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$970.88
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$970.88
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,024.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,078.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,024.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,078.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,078.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$809.06
|
| Rate for Payer: Healthfirst Commercial |
$1,078.75
|
| Rate for Payer: Healthfirst Essential Plan |
$2,427.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,024.81
|
| Rate for Payer: Healthfirst QHP |
$1,078.75
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$755.12
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,078.75
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$916.94
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$755.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,078.75
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$809.06
|
| Rate for Payer: SOMOS Essential |
$809.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,078.75
|
|
|
PR THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT
|
Professional
|
Both
|
$5,830.76
|
|
|
Service Code
|
HCPCS 60252
|
| Min. Negotiated Rate |
$1,080.48 |
| Max. Negotiated Rate |
$3,472.99 |
| Rate for Payer: Cash Price |
$1,561.79
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,543.55
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,389.19
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,389.19
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,466.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,543.55
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,466.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,543.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,543.55
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,157.66
|
| Rate for Payer: Healthfirst Commercial |
$1,543.55
|
| Rate for Payer: Healthfirst Essential Plan |
$3,472.99
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,466.37
|
| Rate for Payer: Healthfirst QHP |
$1,543.55
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,080.48
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,543.55
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,312.02
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,080.48
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,543.55
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,157.66
|
| Rate for Payer: SOMOS Essential |
$1,157.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,543.55
|
|
|
PR THYROIDECTOMY TOTAL/SUBTOTAL RAD NECK DISSECT
|
Professional
|
Both
|
$7,325.19
|
|
|
Service Code
|
HCPCS 60254
|
| Min. Negotiated Rate |
$1,364.24 |
| Max. Negotiated Rate |
$4,385.05 |
| Rate for Payer: Cash Price |
$1,966.76
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,948.91
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,754.02
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,754.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,851.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,948.91
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,851.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,948.91
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,948.91
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,461.68
|
| Rate for Payer: Healthfirst Commercial |
$1,948.91
|
| Rate for Payer: Healthfirst Essential Plan |
$4,385.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,851.46
|
| Rate for Payer: Healthfirst QHP |
$1,948.91
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,364.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,948.91
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,656.57
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,364.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,948.91
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,461.68
|
| Rate for Payer: SOMOS Essential |
$1,461.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,948.91
|
|
|
PR THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC
|
Professional
|
Both
|
$6,042.82
|
|
|
Service Code
|
HCPCS 60270
|
| Min. Negotiated Rate |
$1,116.92 |
| Max. Negotiated Rate |
$3,590.10 |
| Rate for Payer: Cash Price |
$1,612.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,595.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,436.04
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,436.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,515.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,595.60
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,515.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,595.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,595.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,196.70
|
| Rate for Payer: Healthfirst Commercial |
$1,595.60
|
| Rate for Payer: Healthfirst Essential Plan |
$3,590.10
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,515.82
|
| Rate for Payer: Healthfirst QHP |
$1,595.60
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,116.92
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,595.60
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,356.26
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,116.92
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,595.60
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,196.70
|
| Rate for Payer: SOMOS Essential |
$1,196.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,595.60
|
|
|
PR TIS CRTJ ST CONGENITAL CARDIAC ANOMAL 1ST SHUNT
|
Professional
|
Both
|
$4,719.37
|
|
|
Service Code
|
HCPCS 33745
|
| Min. Negotiated Rate |
$867.08 |
| Max. Negotiated Rate |
$2,787.03 |
| Rate for Payer: Cash Price |
$1,253.50
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,238.68
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,114.81
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,114.81
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,176.75
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,238.68
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,176.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,238.68
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,238.68
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$929.01
|
| Rate for Payer: Healthfirst Commercial |
$1,238.68
|
| Rate for Payer: Healthfirst Essential Plan |
$2,787.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,176.75
|
| Rate for Payer: Healthfirst QHP |
$1,238.68
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$867.08
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,238.68
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,052.88
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$867.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,238.68
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$929.01
|
| Rate for Payer: SOMOS Essential |
$929.01
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,238.68
|
|
|
PR TIS CRTJ ST CONGENITAL CARDIAC ANOMAL EA ADDL
|
Professional
|
Both
|
$1,884.19
|
|
|
Service Code
|
HCPCS 33746
|
| Min. Negotiated Rate |
$346.23 |
| Max. Negotiated Rate |
$1,112.87 |
| Rate for Payer: Cash Price |
$500.99
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$494.61
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$445.15
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$445.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$469.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$494.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$469.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$494.61
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$494.61
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$370.96
|
| Rate for Payer: Healthfirst Commercial |
$494.61
|
| Rate for Payer: Healthfirst Essential Plan |
$1,112.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$469.88
|
| Rate for Payer: Healthfirst QHP |
$494.61
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$346.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$494.61
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$420.42
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$346.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$494.61
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$370.96
|
| Rate for Payer: SOMOS Essential |
$370.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$494.61
|
|
|
PR TISSUE EXPANDER PLACEMENT BREAST RECONSTRUCTION
|
Professional
|
Both
|
$5,074.86
|
|
|
Service Code
|
HCPCS 19357
|
| Min. Negotiated Rate |
$956.96 |
| Max. Negotiated Rate |
$3,075.95 |
| Rate for Payer: Cash Price |
$1,371.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,367.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,230.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,230.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,298.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,367.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,298.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,367.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,367.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,025.32
|
| Rate for Payer: Healthfirst Commercial |
$1,367.09
|
| Rate for Payer: Healthfirst Essential Plan |
$3,075.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,298.74
|
| Rate for Payer: Healthfirst QHP |
$1,367.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$956.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,367.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,162.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$956.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,367.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,025.32
|
| Rate for Payer: SOMOS Essential |
$1,025.32
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,367.09
|
|
|
PR TMPP ANTRT/MASTOIDOTOMY PROSTHESIS TORP
|
Professional
|
Both
|
$6,094.94
|
|
|
Service Code
|
HCPCS 69637
|
| Min. Negotiated Rate |
$1,133.08 |
| Max. Negotiated Rate |
$3,642.05 |
| Rate for Payer: Cash Price |
$1,642.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,618.69
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,456.82
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,456.82
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,537.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,618.69
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,537.76
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,618.69
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,618.69
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,214.02
|
| Rate for Payer: Healthfirst Commercial |
$1,618.69
|
| Rate for Payer: Healthfirst Essential Plan |
$3,642.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,537.76
|
| Rate for Payer: Healthfirst QHP |
$1,618.69
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,133.08
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,618.69
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,375.89
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,133.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,618.69
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,214.02
|
| Rate for Payer: SOMOS Essential |
$1,214.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,618.69
|
|
|
PR TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR
|
Professional
|
Both
|
$6,552.53
|
|
|
Service Code
|
HCPCS 69644
|
| Min. Negotiated Rate |
$1,219.23 |
| Max. Negotiated Rate |
$3,918.96 |
| Rate for Payer: Cash Price |
$1,762.01
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,741.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,567.58
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,567.58
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,654.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,741.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,654.67
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,741.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,741.76
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,306.32
|
| Rate for Payer: Healthfirst Commercial |
$1,741.76
|
| Rate for Payer: Healthfirst Essential Plan |
$3,918.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,654.67
|
| Rate for Payer: Healthfirst QHP |
$1,741.76
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,219.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,741.76
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,480.50
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,219.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,741.76
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,306.32
|
| Rate for Payer: SOMOS Essential |
$1,306.32
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,741.76
|
|
|
PR TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR
|
Professional
|
Both
|
$5,323.92
|
|
|
Service Code
|
HCPCS 69643
|
| Min. Negotiated Rate |
$983.57 |
| Max. Negotiated Rate |
$3,161.47 |
| Rate for Payer: Cash Price |
$1,432.04
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,405.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,264.59
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,264.59
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,334.85
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,405.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,334.85
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,405.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,405.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,053.83
|
| Rate for Payer: Healthfirst Commercial |
$1,405.10
|
| Rate for Payer: Healthfirst Essential Plan |
$3,161.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,334.85
|
| Rate for Payer: Healthfirst QHP |
$1,405.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$983.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,405.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,194.34
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$983.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,405.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,053.83
|
| Rate for Payer: SOMOS Essential |
$1,053.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,405.10
|
|
|
PR TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ
|
Professional
|
Both
|
$4,535.62
|
|
|
Service Code
|
HCPCS 69641
|
| Min. Negotiated Rate |
$839.03 |
| Max. Negotiated Rate |
$2,696.89 |
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,198.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,078.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,078.76
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,138.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,198.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,138.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,198.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,198.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$898.97
|
| Rate for Payer: Healthfirst Commercial |
$1,198.62
|
| Rate for Payer: Healthfirst Essential Plan |
$2,696.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,138.69
|
| Rate for Payer: Healthfirst QHP |
$1,198.62
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$839.03
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,198.62
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,018.83
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$839.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,198.62
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$898.97
|
| Rate for Payer: SOMOS Essential |
$898.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,198.62
|
|
|
PR TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ
|
Professional
|
Both
|
$5,810.42
|
|
|
Service Code
|
HCPCS 69642
|
| Min. Negotiated Rate |
$1,074.95 |
| Max. Negotiated Rate |
$3,455.21 |
| Rate for Payer: Cash Price |
$1,567.41
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,535.65
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,382.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,382.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,458.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,535.65
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,458.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,535.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,535.65
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,151.74
|
| Rate for Payer: Healthfirst Commercial |
$1,535.65
|
| Rate for Payer: Healthfirst Essential Plan |
$3,455.21
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,458.87
|
| Rate for Payer: Healthfirst QHP |
$1,535.65
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,074.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,535.65
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,305.30
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,074.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,535.65
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,151.74
|
| Rate for Payer: SOMOS Essential |
$1,151.74
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,535.65
|
|
|
PR TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN
|
Professional
|
Both
|
$2,197.27
|
|
|
Service Code
|
HCPCS 27681
|
| Min. Negotiated Rate |
$421.27 |
| Max. Negotiated Rate |
$1,354.07 |
| Rate for Payer: Cash Price |
$602.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$601.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$541.63
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$541.63
|
| Rate for Payer: Fidelis Essential Plan QHP |
$571.72
|
| Rate for Payer: Fidelis Medicare Advantage |
$601.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$571.72
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$601.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$601.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$451.36
|
| Rate for Payer: Healthfirst Commercial |
$601.81
|
| Rate for Payer: Healthfirst Essential Plan |
$1,354.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$571.72
|
| Rate for Payer: Healthfirst QHP |
$601.81
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$421.27
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$601.81
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$511.54
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$421.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$601.81
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$451.36
|
| Rate for Payer: SOMOS Essential |
$451.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$601.81
|
|
|
PR TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA
|
Professional
|
Both
|
$2,336.57
|
|
|
Service Code
|
HCPCS 25295
|
| Min. Negotiated Rate |
$443.06 |
| Max. Negotiated Rate |
$1,424.14 |
| Rate for Payer: Cash Price |
$634.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$632.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$569.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$569.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$601.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$632.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$601.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$632.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$632.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$474.71
|
| Rate for Payer: Healthfirst Commercial |
$632.95
|
| Rate for Payer: Healthfirst Essential Plan |
$1,424.14
|
| Rate for Payer: Healthfirst Medicare Advantage |
$601.30
|
| Rate for Payer: Healthfirst QHP |
$632.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$443.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$632.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$538.01
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$443.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$632.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$474.71
|
| Rate for Payer: SOMOS Essential |
$474.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$632.95
|
|
