|
PR VALVOTOMY MITRAL VALVE CLOSED HEART
|
Professional
|
Both
|
$6,391.04
|
|
|
Service Code
|
HCPCS 33420
|
| Min. Negotiated Rate |
$1,180.43 |
| Max. Negotiated Rate |
$3,794.24 |
| Rate for Payer: Cash Price |
$1,700.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,686.33
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,517.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,517.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,602.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,686.33
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,602.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,686.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,686.33
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,264.75
|
| Rate for Payer: Healthfirst Commercial |
$1,686.33
|
| Rate for Payer: Healthfirst Essential Plan |
$3,794.24
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,602.01
|
| Rate for Payer: Healthfirst QHP |
$1,686.33
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,180.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,686.33
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,433.38
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,180.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,686.33
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,264.75
|
| Rate for Payer: SOMOS Essential |
$1,264.75
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,686.33
|
|
|
PR VALVOTOMY MITRAL VALVE OPEN HEART W/BYPASS
|
Professional
|
Both
|
$7,329.28
|
|
|
Service Code
|
HCPCS 33422
|
| Min. Negotiated Rate |
$1,353.51 |
| Max. Negotiated Rate |
$4,350.56 |
| Rate for Payer: Cash Price |
$1,947.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,933.58
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,740.22
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,740.22
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,836.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,933.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,836.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,933.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,933.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,450.18
|
| Rate for Payer: Healthfirst Commercial |
$1,933.58
|
| Rate for Payer: Healthfirst Essential Plan |
$4,350.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,836.90
|
| Rate for Payer: Healthfirst QHP |
$1,933.58
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,353.51
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,933.58
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,643.54
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,353.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,933.58
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,450.18
|
| Rate for Payer: SOMOS Essential |
$1,450.18
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,933.58
|
|
|
PR VALVOTOMY PULMONARY VALVE OPEN HEART W/BYPASS
|
Professional
|
Both
|
$9,700.46
|
|
|
Service Code
|
HCPCS 33474
|
| Min. Negotiated Rate |
$1,784.85 |
| Max. Negotiated Rate |
$5,737.01 |
| Rate for Payer: Cash Price |
$2,576.46
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,549.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,294.80
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,294.80
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,422.29
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,549.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,422.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,549.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,549.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,912.34
|
| Rate for Payer: Healthfirst Commercial |
$2,549.78
|
| Rate for Payer: Healthfirst Essential Plan |
$5,737.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,422.29
|
| Rate for Payer: Healthfirst QHP |
$2,549.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,784.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,549.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,167.31
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,784.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,549.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,912.34
|
| Rate for Payer: SOMOS Essential |
$1,912.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,549.78
|
|
|
PR VALVOTOMY PULM VALVE CLSD HEART VIA PULM ARTERY
|
Professional
|
Both
|
$5,902.33
|
|
|
Service Code
|
HCPCS 33471
|
| Rate for Payer: Cash Price |
$1,571.82
|
|
|
PR VALVULOPLASTY AORTIC VALVE OPEN CARD BYP COMPLEX
|
Professional
|
Both
|
$10,090.57
|
|
|
Service Code
|
HCPCS 33391
|
| Min. Negotiated Rate |
$1,859.92 |
| Max. Negotiated Rate |
$5,978.32 |
| Rate for Payer: Cash Price |
$2,675.91
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,657.03
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,391.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,391.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,524.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,657.03
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,524.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,657.03
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,657.03
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,992.77
|
| Rate for Payer: Healthfirst Commercial |
$2,657.03
|
| Rate for Payer: Healthfirst Essential Plan |
$5,978.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,524.18
|
| Rate for Payer: Healthfirst QHP |
$2,657.03
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,859.92
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,657.03
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,258.48
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,859.92
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,657.03
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,992.77
|
| Rate for Payer: SOMOS Essential |
$1,992.77
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,657.03
|
|
|
PR VALVULOPLASTY AORTIC VALVE OPEN CARD BYP SIMPLE
|
Professional
|
Both
|
$8,519.18
|
|
|
Service Code
|
HCPCS 33390
|
| Min. Negotiated Rate |
$1,568.51 |
| Max. Negotiated Rate |
$5,041.64 |
| Rate for Payer: Cash Price |
$2,256.39
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,240.73
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,016.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,016.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,128.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,240.73
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,128.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,240.73
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,240.73
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,680.55
|
| Rate for Payer: Healthfirst Commercial |
$2,240.73
|
| Rate for Payer: Healthfirst Essential Plan |
$5,041.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,128.69
|
| Rate for Payer: Healthfirst QHP |
$2,240.73
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,568.51
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,240.73
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,904.62
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,568.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,240.73
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,680.55
|
| Rate for Payer: SOMOS Essential |
$1,680.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,240.73
|
|
|
PR VALVULOPLASTY FEMORAL VEIN
|
Professional
|
Both
|
$3,972.99
|
|
|
Service Code
|
HCPCS 34501
|
| Min. Negotiated Rate |
$733.43 |
| Max. Negotiated Rate |
$2,357.46 |
| Rate for Payer: Cash Price |
$1,057.65
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,047.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$942.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$942.98
|
| Rate for Payer: Fidelis Essential Plan QHP |
$995.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,047.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$995.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,047.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,047.76
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$785.82
|
| Rate for Payer: Healthfirst Commercial |
$1,047.76
|
| Rate for Payer: Healthfirst Essential Plan |
$2,357.46
|
| Rate for Payer: Healthfirst Medicare Advantage |
$995.37
|
| Rate for Payer: Healthfirst QHP |
$1,047.76
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$733.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,047.76
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$890.60
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$733.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,047.76
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$785.82
|
| Rate for Payer: SOMOS Essential |
$785.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,047.76
|
|
|
PR VALVULOPLASTY MITRAL VALVE W/CARDIAC BYPASS
|
Professional
|
Both
|
$12,085.29
|
|
|
Service Code
|
HCPCS 33425
|
| Min. Negotiated Rate |
$2,221.47 |
| Max. Negotiated Rate |
$7,140.44 |
| Rate for Payer: Cash Price |
$3,210.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,173.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,856.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,856.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,014.85
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,173.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,014.85
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,173.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,173.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,380.15
|
| Rate for Payer: Healthfirst Commercial |
$3,173.53
|
| Rate for Payer: Healthfirst Essential Plan |
$7,140.44
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,014.85
|
| Rate for Payer: Healthfirst QHP |
$3,173.53
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,221.47
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,173.53
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,697.50
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,221.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,173.53
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,380.15
|
| Rate for Payer: SOMOS Essential |
$2,380.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,173.53
|
|
|
PR VALVULOPLASTY TRICUSPID VALVE W/O RING INSERTION
|
Professional
|
Both
|
$13,455.02
|
|
|
Service Code
|
HCPCS 33463
|
| Min. Negotiated Rate |
$2,496.33 |
| Max. Negotiated Rate |
$8,023.90 |
| Rate for Payer: Cash Price |
$3,601.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,566.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,209.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,209.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,387.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,566.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,387.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,566.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,566.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,674.64
|
| Rate for Payer: Healthfirst Commercial |
$3,566.18
|
| Rate for Payer: Healthfirst Essential Plan |
$8,023.90
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,387.87
|
| Rate for Payer: Healthfirst QHP |
$3,566.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,496.33
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,566.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$3,031.25
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,496.33
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,566.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,674.64
|
| Rate for Payer: SOMOS Essential |
$2,674.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,566.18
|
|
|
PR VALVULOPLASTY TRICUSPID VALVE W/RING INSERTION
|
Professional
|
Both
|
$10,750.60
|
|
|
Service Code
|
HCPCS 33464
|
| Min. Negotiated Rate |
$1,980.97 |
| Max. Negotiated Rate |
$6,367.41 |
| Rate for Payer: Cash Price |
$2,859.91
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,829.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,546.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,546.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,688.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,829.96
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,688.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,829.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,829.96
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,122.47
|
| Rate for Payer: Healthfirst Commercial |
$2,829.96
|
| Rate for Payer: Healthfirst Essential Plan |
$6,367.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,688.46
|
| Rate for Payer: Healthfirst QHP |
$2,829.96
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,980.97
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,829.96
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,405.47
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,980.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,829.96
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,122.47
|
| Rate for Payer: SOMOS Essential |
$2,122.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,829.96
|
|
|
PR VASC ENDOSCOPY SURG W/LIG PERFORATOR VEINS SPX
|
Professional
|
Both
|
$2,806.69
|
|
|
Service Code
|
HCPCS 37500
|
| Min. Negotiated Rate |
$516.73 |
| Max. Negotiated Rate |
$1,660.90 |
| Rate for Payer: Cash Price |
$745.37
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$738.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$664.36
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$664.36
|
| Rate for Payer: Fidelis Essential Plan QHP |
$701.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$738.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$701.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$738.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$738.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$553.63
|
| Rate for Payer: Healthfirst Commercial |
$738.18
|
| Rate for Payer: Healthfirst Essential Plan |
$1,660.90
|
| Rate for Payer: Healthfirst Medicare Advantage |
$701.27
|
| Rate for Payer: Healthfirst QHP |
$738.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$516.73
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$738.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$627.45
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$516.73
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$738.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$553.63
|
| Rate for Payer: SOMOS Essential |
$553.63
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$738.18
|
|
|
PR VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I
|
Professional
|
Both
|
$2,008.58
|
|
|
Service Code
|
HCPCS 37242
|
| Min. Negotiated Rate |
$371.60 |
| Max. Negotiated Rate |
$1,194.41 |
| Rate for Payer: Cash Price |
$536.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$530.85
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$477.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$477.76
|
| Rate for Payer: Fidelis Essential Plan QHP |
$504.31
|
| Rate for Payer: Fidelis Medicare Advantage |
$530.85
|
| Rate for Payer: Fidelis Qualified Health Plan |
$504.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$530.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$530.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$398.14
|
| Rate for Payer: Healthfirst Commercial |
$530.85
|
| Rate for Payer: Healthfirst Essential Plan |
$1,194.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$504.31
|
| Rate for Payer: Healthfirst QHP |
$530.85
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$371.60
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$530.85
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$451.22
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$371.60
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$530.85
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$398.14
|
| Rate for Payer: SOMOS Essential |
$398.14
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$530.85
|
|
|
PR VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE
|
Professional
|
Both
|
$2,703.96
|
|
|
Service Code
|
HCPCS 37244
|
| Min. Negotiated Rate |
$505.76 |
| Max. Negotiated Rate |
$1,625.67 |
| Rate for Payer: Cash Price |
$727.39
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$722.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$650.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$650.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$686.39
|
| Rate for Payer: Fidelis Medicare Advantage |
$722.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$686.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$722.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$722.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$541.89
|
| Rate for Payer: Healthfirst Commercial |
$722.52
|
| Rate for Payer: Healthfirst Essential Plan |
$1,625.67
|
| Rate for Payer: Healthfirst Medicare Advantage |
$686.39
|
| Rate for Payer: Healthfirst QHP |
$722.52
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$505.76
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$722.52
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$614.14
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$505.76
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$722.52
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$541.89
|
| Rate for Payer: SOMOS Essential |
$541.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$722.52
|
|
|
PR VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I
|
Professional
|
Both
|
$1,806.56
|
|
|
Service Code
|
HCPCS 37241
|
| Min. Negotiated Rate |
$332.63 |
| Max. Negotiated Rate |
$1,069.18 |
| Rate for Payer: Cash Price |
$479.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$475.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$427.67
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$427.67
|
| Rate for Payer: Fidelis Essential Plan QHP |
$451.43
|
| Rate for Payer: Fidelis Medicare Advantage |
$475.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$451.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$475.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$475.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$356.39
|
| Rate for Payer: Healthfirst Commercial |
$475.19
|
| Rate for Payer: Healthfirst Essential Plan |
$1,069.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$451.43
|
| Rate for Payer: Healthfirst QHP |
$475.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$332.63
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$475.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$403.91
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$332.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$475.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$356.39
|
| Rate for Payer: SOMOS Essential |
$356.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$475.19
|
|
|
PR VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT
|
Professional
|
Both
|
$2,283.19
|
|
|
Service Code
|
HCPCS 37243
|
| Min. Negotiated Rate |
$429.68 |
| Max. Negotiated Rate |
$1,381.12 |
| Rate for Payer: Cash Price |
$615.64
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$613.83
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$552.45
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$552.45
|
| Rate for Payer: Fidelis Essential Plan QHP |
$583.14
|
| Rate for Payer: Fidelis Medicare Advantage |
$613.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$583.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$613.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$613.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$460.37
|
| Rate for Payer: Healthfirst Commercial |
$613.83
|
| Rate for Payer: Healthfirst Essential Plan |
$1,381.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$583.14
|
| Rate for Payer: Healthfirst QHP |
$613.83
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$429.68
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$613.83
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$521.76
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$429.68
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$613.83
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$460.37
|
| Rate for Payer: SOMOS Essential |
$460.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$613.83
|
|
|
PR VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS
|
Professional
|
Both
|
$967.09
|
|
|
Service Code
|
HCPCS 55250
|
| Min. Negotiated Rate |
$186.07 |
| Max. Negotiated Rate |
$598.07 |
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$265.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$239.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$239.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$252.52
|
| Rate for Payer: Fidelis Medicare Advantage |
$265.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$252.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$265.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$265.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$199.36
|
| Rate for Payer: Healthfirst Commercial |
$265.81
|
| Rate for Payer: Healthfirst Essential Plan |
$598.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$252.52
|
| Rate for Payer: Healthfirst QHP |
$265.81
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$186.07
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$265.81
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$225.94
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$186.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$265.81
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$199.36
|
| Rate for Payer: SOMOS Essential |
$199.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$265.81
|
|
|
PR VASOTOMY CANNULIZATION W/WO VAS INC UNI/BI SPX
|
Professional
|
Both
|
$1,170.30
|
|
|
Service Code
|
HCPCS 55200
|
| Min. Negotiated Rate |
$224.00 |
| Max. Negotiated Rate |
$720.00 |
| Rate for Payer: Cash Price |
$321.18
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$320.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$288.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$288.00
|
| Rate for Payer: Fidelis Essential Plan QHP |
$304.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$320.00
|
| Rate for Payer: Fidelis Qualified Health Plan |
$304.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$320.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$320.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$240.00
|
| Rate for Payer: Healthfirst Commercial |
$320.00
|
| Rate for Payer: Healthfirst Essential Plan |
$720.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$304.00
|
| Rate for Payer: Healthfirst QHP |
$320.00
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$224.00
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$320.00
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$272.00
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$224.00
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$320.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$240.00
|
| Rate for Payer: SOMOS Essential |
$240.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$320.00
|
|
|
PR VASOTOMY VASOGRAMS UNI/BI
|
Professional
|
Both
|
$774.66
|
|
|
Service Code
|
HCPCS 55300
|
| Min. Negotiated Rate |
$147.29 |
| Max. Negotiated Rate |
$473.44 |
| Rate for Payer: Cash Price |
$210.81
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$210.42
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$189.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$189.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$199.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$210.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$199.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$210.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$210.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$157.81
|
| Rate for Payer: Healthfirst Commercial |
$210.42
|
| Rate for Payer: Healthfirst Essential Plan |
$473.44
|
| Rate for Payer: Healthfirst Medicare Advantage |
$199.90
|
| Rate for Payer: Healthfirst QHP |
$210.42
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$147.29
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$210.42
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$178.86
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$147.29
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$210.42
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$157.81
|
| Rate for Payer: SOMOS Essential |
$157.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$210.42
|
|
|
PR VASOVASOSTOMY VASOVASORRHAPHY
|
Professional
|
Both
|
$2,097.80
|
|
|
Service Code
|
HCPCS 55400
|
| Min. Negotiated Rate |
$400.44 |
| Max. Negotiated Rate |
$1,287.11 |
| Rate for Payer: Cash Price |
$576.64
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$572.05
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$514.85
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$514.85
|
| Rate for Payer: Fidelis Essential Plan QHP |
$543.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$572.05
|
| Rate for Payer: Fidelis Qualified Health Plan |
$543.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$572.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$572.05
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$429.04
|
| Rate for Payer: Healthfirst Commercial |
$572.05
|
| Rate for Payer: Healthfirst Essential Plan |
$1,287.11
|
| Rate for Payer: Healthfirst Medicare Advantage |
$543.45
|
| Rate for Payer: Healthfirst QHP |
$572.05
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$400.44
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$572.05
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$486.24
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$400.44
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$572.05
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$429.04
|
| Rate for Payer: SOMOS Essential |
$429.04
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$572.05
|
|
|
PR VCRPEC LAT XTRCAVITARY DCMPRN THRC/LMBR EA SEG
|
Professional
|
Both
|
$1,376.83
|
|
|
Service Code
|
HCPCS 63103
|
| Min. Negotiated Rate |
$249.16 |
| Max. Negotiated Rate |
$800.89 |
| Rate for Payer: Cash Price |
$360.24
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$355.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$320.36
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$320.36
|
| Rate for Payer: Fidelis Essential Plan QHP |
$338.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$355.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$338.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$355.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$355.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$266.96
|
| Rate for Payer: Healthfirst Commercial |
$355.95
|
| Rate for Payer: Healthfirst Essential Plan |
$800.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$338.15
|
| Rate for Payer: Healthfirst QHP |
$355.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$249.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$355.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$302.56
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$249.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$355.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$266.96
|
| Rate for Payer: SOMOS Essential |
$266.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$355.95
|
|
|
PR VCRPEC LES 1 SEG IDRL LMBR/SAC TRANSPRTL/RPR
|
Professional
|
Both
|
$11,622.91
|
|
|
Service Code
|
HCPCS 63307
|
| Min. Negotiated Rate |
$2,121.88 |
| Max. Negotiated Rate |
$6,820.31 |
| Rate for Payer: Cash Price |
$3,059.90
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,031.25
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,728.12
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,728.12
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,879.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,031.25
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,879.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,031.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,031.25
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,273.44
|
| Rate for Payer: Healthfirst Commercial |
$3,031.25
|
| Rate for Payer: Healthfirst Essential Plan |
$6,820.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,879.69
|
| Rate for Payer: Healthfirst QHP |
$3,031.25
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,121.88
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,031.25
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,576.56
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,121.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,031.25
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,273.44
|
| Rate for Payer: SOMOS Essential |
$2,273.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,031.25
|
|
|
PR VCRPEC LES 1 SEG XDRL LMBR/SAC TRANSPRTL/RPR
|
Professional
|
Both
|
$11,183.69
|
|
|
Service Code
|
HCPCS 63303
|
| Min. Negotiated Rate |
$2,040.88 |
| Max. Negotiated Rate |
$6,559.97 |
| Rate for Payer: Cash Price |
$2,944.18
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,915.54
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,623.99
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,623.99
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,769.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,915.54
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,769.76
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,915.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,915.54
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,186.66
|
| Rate for Payer: Healthfirst Commercial |
$2,915.54
|
| Rate for Payer: Healthfirst Essential Plan |
$6,559.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,769.76
|
| Rate for Payer: Healthfirst QHP |
$2,915.54
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,040.88
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,915.54
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,478.21
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,040.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,915.54
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,186.66
|
| Rate for Payer: SOMOS Essential |
$2,186.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,915.54
|
|
|
PR VCRPEC LES 1 SEG XDRL THRC THORACOLMBR
|
Professional
|
Both
|
$10,521.63
|
|
|
Service Code
|
HCPCS 63302
|
| Min. Negotiated Rate |
$1,923.59 |
| Max. Negotiated Rate |
$6,182.98 |
| Rate for Payer: Cash Price |
$2,774.34
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,747.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,473.19
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,473.19
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,610.59
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,747.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,610.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,747.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,747.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,060.99
|
| Rate for Payer: Healthfirst Commercial |
$2,747.99
|
| Rate for Payer: Healthfirst Essential Plan |
$6,182.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,610.59
|
| Rate for Payer: Healthfirst QHP |
$2,747.99
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,923.59
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,747.99
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,335.79
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,923.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,747.99
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,060.99
|
| Rate for Payer: SOMOS Essential |
$2,060.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,747.99
|
|
|
PR VCRPEC LES 1 SGM XDRL CERVICAL
|
Professional
|
Both
|
$8,526.46
|
|
|
Service Code
|
HCPCS 63300
|
| Min. Negotiated Rate |
$1,575.90 |
| Max. Negotiated Rate |
$5,065.40 |
| Rate for Payer: Cash Price |
$2,253.24
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,251.29
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,026.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,026.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,138.73
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,251.29
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,138.73
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,251.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,251.29
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,688.47
|
| Rate for Payer: Healthfirst Commercial |
$2,251.29
|
| Rate for Payer: Healthfirst Essential Plan |
$5,065.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,138.73
|
| Rate for Payer: Healthfirst QHP |
$2,251.29
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,575.90
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,251.29
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,913.60
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,575.90
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,251.29
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,688.47
|
| Rate for Payer: SOMOS Essential |
$1,688.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,251.29
|
|
|
PR VCRPEC LES 1 SGM XDRL THORACIC TTHRC
|
Professional
|
Both
|
$10,654.98
|
|
|
Service Code
|
HCPCS 63301
|
| Min. Negotiated Rate |
$1,845.81 |
| Max. Negotiated Rate |
$5,932.96 |
| Rate for Payer: Cash Price |
$2,808.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,636.87
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,373.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,373.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,505.03
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,636.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,505.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,636.87
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,636.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,977.65
|
| Rate for Payer: Healthfirst Commercial |
$2,636.87
|
| Rate for Payer: Healthfirst Essential Plan |
$5,932.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,505.03
|
| Rate for Payer: Healthfirst QHP |
$2,636.87
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,845.81
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,636.87
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,241.34
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,845.81
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,636.87
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,977.65
|
| Rate for Payer: SOMOS Essential |
$1,977.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,636.87
|
|
