|
CHG THYROID IMAGING WITH VASCULAR FLOW
|
Professional
|
Both
|
$70.49
|
|
|
Service Code
|
HCPCS 78013 26
|
| Min. Negotiated Rate |
$13.05 |
| Max. Negotiated Rate |
$41.94 |
| Rate for Payer: Cash Price |
$18.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$18.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$16.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$16.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$17.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$18.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$17.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$13.98
|
| Rate for Payer: Healthfirst Commercial |
$18.64
|
| Rate for Payer: Healthfirst Essential Plan |
$41.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17.71
|
| Rate for Payer: Healthfirst QHP |
$18.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$13.05
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$18.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$15.84
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$13.05
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$18.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$13.98
|
| Rate for Payer: SOMOS Essential |
$13.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$18.64
|
|
|
CHG THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT
|
Professional
|
Both
|
$35.18
|
|
|
Service Code
|
HCPCS 78012 26
|
| Min. Negotiated Rate |
$6.64 |
| Max. Negotiated Rate |
$21.35 |
| Rate for Payer: Cash Price |
$9.61
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$9.02
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$9.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.12
|
| Rate for Payer: Healthfirst Commercial |
$9.49
|
| Rate for Payer: Healthfirst Essential Plan |
$21.35
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.02
|
| Rate for Payer: Healthfirst QHP |
$9.49
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$6.64
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$9.49
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$8.07
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$6.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.49
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$7.12
|
| Rate for Payer: SOMOS Essential |
$7.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.49
|
|
|
CHG THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT
|
Professional
|
Both
|
$350.84
|
|
|
Service Code
|
HCPCS 78012
|
| Min. Negotiated Rate |
$66.09 |
| Max. Negotiated Rate |
$212.42 |
| Rate for Payer: Cash Price |
$95.57
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$94.41
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$84.97
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$84.97
|
| Rate for Payer: Fidelis Essential Plan QHP |
$89.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$94.41
|
| Rate for Payer: Fidelis Qualified Health Plan |
$89.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$94.41
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$94.41
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$70.81
|
| Rate for Payer: Healthfirst Commercial |
$94.41
|
| Rate for Payer: Healthfirst Essential Plan |
$212.42
|
| Rate for Payer: Healthfirst Medicare Advantage |
$89.69
|
| Rate for Payer: Healthfirst QHP |
$94.41
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$66.09
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$94.41
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$80.25
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$66.09
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$94.41
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$70.81
|
| Rate for Payer: SOMOS Essential |
$70.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$94.41
|
|
|
CHG THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT
|
Professional
|
Both
|
$315.70
|
|
|
Service Code
|
HCPCS 78012 TC
|
| Min. Negotiated Rate |
$59.44 |
| Max. Negotiated Rate |
$191.07 |
| Rate for Payer: Cash Price |
$85.96
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$84.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$76.43
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$76.43
|
| Rate for Payer: Fidelis Essential Plan QHP |
$80.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$84.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$80.67
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$84.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$84.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$63.69
|
| Rate for Payer: Healthfirst Commercial |
$84.92
|
| Rate for Payer: Healthfirst Essential Plan |
$191.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$80.67
|
| Rate for Payer: Healthfirst QHP |
$84.92
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$59.44
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$84.92
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$72.18
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$59.44
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$84.92
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$63.69
|
| Rate for Payer: SOMOS Essential |
$63.69
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$84.92
|
|
|
CHG THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS
|
Professional
|
Both
|
$863.38
|
|
|
Service Code
|
HCPCS 78014 TC
|
| Min. Negotiated Rate |
$156.06 |
| Max. Negotiated Rate |
$501.64 |
| Rate for Payer: Cash Price |
$230.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$222.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$200.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$200.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$211.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$222.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$211.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$222.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$222.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$167.21
|
| Rate for Payer: Healthfirst Commercial |
$222.95
|
| Rate for Payer: Healthfirst Essential Plan |
$501.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$211.80
|
| Rate for Payer: Healthfirst QHP |
$222.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$156.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$222.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$189.51
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$156.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$222.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$167.21
|
| Rate for Payer: SOMOS Essential |
$167.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$222.95
|
|
|
CHG THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS
|
Professional
|
Both
|
$92.54
|
|
|
Service Code
|
HCPCS 78014 26
|
| Min. Negotiated Rate |
$17.54 |
| Max. Negotiated Rate |
$56.38 |
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$25.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$22.55
|
| Rate for Payer: Fidelis Essential Plan QHP |
$23.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$25.06
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$25.06
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18.80
|
| Rate for Payer: Healthfirst Commercial |
$25.06
|
| Rate for Payer: Healthfirst Essential Plan |
$56.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$23.81
|
| Rate for Payer: Healthfirst QHP |
$25.06
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$17.54
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$25.06
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$21.30
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$17.54
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$25.06
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18.80
|
| Rate for Payer: SOMOS Essential |
$18.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$25.06
|
|
|
CHG THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS
|
Professional
|
Both
|
$955.92
|
|
|
Service Code
|
HCPCS 78014
|
| Min. Negotiated Rate |
$173.61 |
| Max. Negotiated Rate |
$558.02 |
| Rate for Payer: Cash Price |
$255.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$248.01
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$223.21
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$223.21
|
| Rate for Payer: Fidelis Essential Plan QHP |
$235.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$248.01
|
| Rate for Payer: Fidelis Qualified Health Plan |
$235.61
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$248.01
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$248.01
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$186.01
|
| Rate for Payer: Healthfirst Commercial |
$248.01
|
| Rate for Payer: Healthfirst Essential Plan |
$558.02
|
| Rate for Payer: Healthfirst Medicare Advantage |
$235.61
|
| Rate for Payer: Healthfirst QHP |
$248.01
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$173.61
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$248.01
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$210.81
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$173.61
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$248.01
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$186.01
|
| Rate for Payer: SOMOS Essential |
$186.01
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$248.01
|
|
|
CHG TRANSCATHETER BIOPSY RS&I
|
Professional
|
Both
|
$153.44
|
|
|
Service Code
|
HCPCS 75970 26
|
| Min. Negotiated Rate |
$28.43 |
| Max. Negotiated Rate |
$91.37 |
| Rate for Payer: Cash Price |
$41.34
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$40.61
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$36.55
|
| Rate for Payer: Fidelis Essential Plan QHP |
$38.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$40.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$38.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40.61
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$40.61
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30.46
|
| Rate for Payer: Healthfirst Commercial |
$40.61
|
| Rate for Payer: Healthfirst Essential Plan |
$91.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$38.58
|
| Rate for Payer: Healthfirst QHP |
$40.61
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$28.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$40.61
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$34.52
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$28.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$40.61
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$30.46
|
| Rate for Payer: SOMOS Essential |
$30.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$40.61
|
|
|
CHG TRANSCATHETER EMBOLIZATION ANY METH RS&I
|
Professional
|
Both
|
$311.40
|
|
|
Service Code
|
HCPCS 75894 26
|
| Min. Negotiated Rate |
$58.65 |
| Max. Negotiated Rate |
$188.50 |
| Rate for Payer: Cash Price |
$83.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$83.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$75.40
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$75.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$79.59
|
| Rate for Payer: Fidelis Medicare Advantage |
$83.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$79.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$83.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$83.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$62.84
|
| Rate for Payer: Healthfirst Commercial |
$83.78
|
| Rate for Payer: Healthfirst Essential Plan |
$188.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$79.59
|
| Rate for Payer: Healthfirst QHP |
$83.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$58.65
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$83.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$71.21
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$58.65
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$83.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$62.84
|
| Rate for Payer: SOMOS Essential |
$62.84
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$83.78
|
|
|
CHG TRANSCERVICAL CATHJ FALLOPIAN TUBE RS&I
|
Professional
|
Both
|
$118.97
|
|
|
Service Code
|
HCPCS 74742 26
|
| Min. Negotiated Rate |
$21.99 |
| Max. Negotiated Rate |
$70.67 |
| Rate for Payer: Cash Price |
$31.79
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$31.41
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$28.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$28.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$29.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$31.41
|
| Rate for Payer: Fidelis Qualified Health Plan |
$29.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$31.41
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$31.41
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23.56
|
| Rate for Payer: Healthfirst Commercial |
$31.41
|
| Rate for Payer: Healthfirst Essential Plan |
$70.67
|
| Rate for Payer: Healthfirst Medicare Advantage |
$29.84
|
| Rate for Payer: Healthfirst QHP |
$31.41
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$21.99
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$31.41
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$26.70
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$21.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$31.41
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23.56
|
| Rate for Payer: SOMOS Essential |
$23.56
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$31.41
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION COMPLEX
|
Professional
|
Both
|
$280.18
|
|
|
Service Code
|
HCPCS 77334 TC
|
| Min. Negotiated Rate |
$53.96 |
| Max. Negotiated Rate |
$173.45 |
| Rate for Payer: Cash Price |
$77.64
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$77.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$69.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$69.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$73.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$77.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$73.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$77.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$77.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$57.82
|
| Rate for Payer: Healthfirst Commercial |
$77.09
|
| Rate for Payer: Healthfirst Essential Plan |
$173.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$73.24
|
| Rate for Payer: Healthfirst QHP |
$77.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$53.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$77.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$65.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$53.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$77.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$57.82
|
| Rate for Payer: SOMOS Essential |
$57.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$77.09
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION COMPLEX
|
Professional
|
Both
|
$521.40
|
|
|
Service Code
|
HCPCS 77334
|
| Min. Negotiated Rate |
$100.54 |
| Max. Negotiated Rate |
$323.17 |
| Rate for Payer: Cash Price |
$144.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$143.63
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$129.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$129.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$136.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$143.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$136.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$143.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$143.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$107.72
|
| Rate for Payer: Healthfirst Commercial |
$143.63
|
| Rate for Payer: Healthfirst Essential Plan |
$323.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$136.45
|
| Rate for Payer: Healthfirst QHP |
$143.63
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$100.54
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$143.63
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$122.09
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$100.54
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$143.63
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$107.72
|
| Rate for Payer: SOMOS Essential |
$107.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$143.63
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION COMPLEX
|
Professional
|
Both
|
$241.22
|
|
|
Service Code
|
HCPCS 77334 26
|
| Min. Negotiated Rate |
$46.58 |
| Max. Negotiated Rate |
$149.72 |
| Rate for Payer: Cash Price |
$66.81
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$66.54
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$59.89
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$59.89
|
| Rate for Payer: Fidelis Essential Plan QHP |
$63.21
|
| Rate for Payer: Fidelis Medicare Advantage |
$66.54
|
| Rate for Payer: Fidelis Qualified Health Plan |
$63.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$66.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$66.54
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$49.91
|
| Rate for Payer: Healthfirst Commercial |
$66.54
|
| Rate for Payer: Healthfirst Essential Plan |
$149.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$63.21
|
| Rate for Payer: Healthfirst QHP |
$66.54
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$46.58
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$66.54
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$56.56
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$46.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$66.54
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$49.91
|
| Rate for Payer: SOMOS Essential |
$49.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$66.54
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE
|
Professional
|
Both
|
$160.93
|
|
|
Service Code
|
HCPCS 77333 26
|
| Min. Negotiated Rate |
$30.79 |
| Max. Negotiated Rate |
$98.98 |
| Rate for Payer: Cash Price |
$43.36
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$43.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$39.59
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$39.59
|
| Rate for Payer: Fidelis Essential Plan QHP |
$41.79
|
| Rate for Payer: Fidelis Medicare Advantage |
$43.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$41.79
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$43.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$43.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$32.99
|
| Rate for Payer: Healthfirst Commercial |
$43.99
|
| Rate for Payer: Healthfirst Essential Plan |
$98.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$41.79
|
| Rate for Payer: Healthfirst QHP |
$43.99
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$30.79
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$43.99
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$37.39
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$30.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$43.99
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$32.99
|
| Rate for Payer: SOMOS Essential |
$32.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$43.99
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE
|
Professional
|
Both
|
$423.92
|
|
|
Service Code
|
HCPCS 77333 TC
|
| Min. Negotiated Rate |
$79.23 |
| Max. Negotiated Rate |
$254.66 |
| Rate for Payer: Cash Price |
$115.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$113.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$101.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$101.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$107.52
|
| Rate for Payer: Fidelis Medicare Advantage |
$113.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$107.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$113.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$113.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$84.89
|
| Rate for Payer: Healthfirst Commercial |
$113.18
|
| Rate for Payer: Healthfirst Essential Plan |
$254.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$107.52
|
| Rate for Payer: Healthfirst QHP |
$113.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$79.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$113.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$96.20
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$79.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$113.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$84.89
|
| Rate for Payer: SOMOS Essential |
$84.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$113.18
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE
|
Professional
|
Both
|
$584.85
|
|
|
Service Code
|
HCPCS 77333
|
| Min. Negotiated Rate |
$110.03 |
| Max. Negotiated Rate |
$353.65 |
| Rate for Payer: Cash Price |
$159.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$157.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$141.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$141.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$149.32
|
| Rate for Payer: Fidelis Medicare Advantage |
$157.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$149.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$157.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$157.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$117.89
|
| Rate for Payer: Healthfirst Commercial |
$157.18
|
| Rate for Payer: Healthfirst Essential Plan |
$353.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$149.32
|
| Rate for Payer: Healthfirst QHP |
$157.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$110.03
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$157.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$133.60
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$110.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$157.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$117.89
|
| Rate for Payer: SOMOS Essential |
$117.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$157.18
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION SIMPLE
|
Professional
|
Both
|
$96.32
|
|
|
Service Code
|
HCPCS 77332 26
|
| Min. Negotiated Rate |
$18.51 |
| Max. Negotiated Rate |
$59.49 |
| Rate for Payer: Cash Price |
$26.37
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$26.44
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.80
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$23.80
|
| Rate for Payer: Fidelis Essential Plan QHP |
$25.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$26.44
|
| Rate for Payer: Fidelis Qualified Health Plan |
$25.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26.44
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19.83
|
| Rate for Payer: Healthfirst Commercial |
$26.44
|
| Rate for Payer: Healthfirst Essential Plan |
$59.49
|
| Rate for Payer: Healthfirst Medicare Advantage |
$25.12
|
| Rate for Payer: Healthfirst QHP |
$26.44
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$18.51
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$26.44
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$22.47
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$18.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26.44
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19.83
|
| Rate for Payer: SOMOS Essential |
$19.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26.44
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION SIMPLE
|
Professional
|
Both
|
$63.11
|
|
|
Service Code
|
HCPCS 77332 TC
|
| Min. Negotiated Rate |
$14.02 |
| Max. Negotiated Rate |
$45.07 |
| Rate for Payer: Cash Price |
$18.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$20.03
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$18.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$19.03
|
| Rate for Payer: Fidelis Medicare Advantage |
$20.03
|
| Rate for Payer: Fidelis Qualified Health Plan |
$19.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$20.03
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$20.03
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$15.02
|
| Rate for Payer: Healthfirst Commercial |
$20.03
|
| Rate for Payer: Healthfirst Essential Plan |
$45.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$19.03
|
| Rate for Payer: Healthfirst QHP |
$20.03
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$14.02
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$20.03
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$17.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$14.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$20.03
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$15.02
|
| Rate for Payer: SOMOS Essential |
$15.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$20.03
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION SIMPLE
|
Professional
|
Both
|
$159.46
|
|
|
Service Code
|
HCPCS 77332
|
| Min. Negotiated Rate |
$32.53 |
| Max. Negotiated Rate |
$104.56 |
| Rate for Payer: Cash Price |
$45.08
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$46.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$41.82
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$41.82
|
| Rate for Payer: Fidelis Essential Plan QHP |
$44.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$46.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$44.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$46.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$46.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$34.85
|
| Rate for Payer: Healthfirst Commercial |
$46.47
|
| Rate for Payer: Healthfirst Essential Plan |
$104.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$44.15
|
| Rate for Payer: Healthfirst QHP |
$46.47
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$32.53
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$46.47
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$39.50
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$32.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$46.47
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$34.85
|
| Rate for Payer: SOMOS Essential |
$34.85
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$46.47
|
|
|
CHG ULTRASONIC GUIDANCE INTRAOPERATIVE
|
Professional
|
Both
|
$263.97
|
|
|
Service Code
|
HCPCS 76998 26
|
| Min. Negotiated Rate |
$37.56 |
| Max. Negotiated Rate |
$120.73 |
| Rate for Payer: Cash Price |
$53.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$53.66
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$48.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$48.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$50.98
|
| Rate for Payer: Fidelis Medicare Advantage |
$53.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$50.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$53.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$53.66
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$40.24
|
| Rate for Payer: Healthfirst Commercial |
$53.66
|
| Rate for Payer: Healthfirst Essential Plan |
$120.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$50.98
|
| Rate for Payer: Healthfirst QHP |
$53.66
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$37.56
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$53.66
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$45.61
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$37.56
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$53.66
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$40.24
|
| Rate for Payer: SOMOS Essential |
$40.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$53.66
|
|
|
CHG ULTRASOUND ELASTOGRAPHY EA ADDL TAGET LESION
|
Professional
|
Both
|
$157.99
|
|
|
Service Code
|
HCPCS 76983 TC
|
| Min. Negotiated Rate |
$29.78 |
| Max. Negotiated Rate |
$95.72 |
| Rate for Payer: Cash Price |
$43.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$42.54
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$38.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$38.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$40.41
|
| Rate for Payer: Fidelis Medicare Advantage |
$42.54
|
| Rate for Payer: Fidelis Qualified Health Plan |
$40.41
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$42.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$42.54
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$31.91
|
| Rate for Payer: Healthfirst Commercial |
$42.54
|
| Rate for Payer: Healthfirst Essential Plan |
$95.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$40.41
|
| Rate for Payer: Healthfirst QHP |
$42.54
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$29.78
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$42.54
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$36.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$29.78
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$42.54
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$31.91
|
| Rate for Payer: SOMOS Essential |
$31.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$42.54
|
|
|
CHG ULTRASOUND ELASTOGRAPHY EA ADDL TAGET LESION
|
Professional
|
Both
|
$260.30
|
|
|
Service Code
|
HCPCS 76983
|
| Min. Negotiated Rate |
$47.41 |
| Max. Negotiated Rate |
$152.39 |
| Rate for Payer: Cash Price |
$71.41
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$67.73
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$60.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$60.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$64.34
|
| Rate for Payer: Fidelis Medicare Advantage |
$67.73
|
| Rate for Payer: Fidelis Qualified Health Plan |
$64.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$67.73
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$67.73
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$50.80
|
| Rate for Payer: Healthfirst Commercial |
$67.73
|
| Rate for Payer: Healthfirst Essential Plan |
$152.39
|
| Rate for Payer: Healthfirst Medicare Advantage |
$64.34
|
| Rate for Payer: Healthfirst QHP |
$67.73
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$47.41
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$67.73
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$57.57
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$47.41
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$67.73
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$50.80
|
| Rate for Payer: SOMOS Essential |
$50.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$67.73
|
|
|
CHG ULTRASOUND ELASTOGRAPHY EA ADDL TAGET LESION
|
Professional
|
Both
|
$102.31
|
|
|
Service Code
|
HCPCS 76983 26
|
| Min. Negotiated Rate |
$17.63 |
| Max. Negotiated Rate |
$56.68 |
| Rate for Payer: Cash Price |
$27.57
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$25.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22.67
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$22.67
|
| Rate for Payer: Fidelis Essential Plan QHP |
$23.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$25.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$25.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18.89
|
| Rate for Payer: Healthfirst Commercial |
$25.19
|
| Rate for Payer: Healthfirst Essential Plan |
$56.68
|
| Rate for Payer: Healthfirst Medicare Advantage |
$23.93
|
| Rate for Payer: Healthfirst QHP |
$25.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$17.63
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$25.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$21.41
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$17.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$25.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$18.89
|
| Rate for Payer: SOMOS Essential |
$18.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$25.19
|
|
|
CHG ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION
|
Professional
|
Both
|
$116.48
|
|
|
Service Code
|
HCPCS 76982 26
|
| Min. Negotiated Rate |
$21.50 |
| Max. Negotiated Rate |
$69.12 |
| Rate for Payer: Cash Price |
$31.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$30.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$27.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$27.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$29.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$30.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$29.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23.04
|
| Rate for Payer: Healthfirst Commercial |
$30.72
|
| Rate for Payer: Healthfirst Essential Plan |
$69.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$29.18
|
| Rate for Payer: Healthfirst QHP |
$30.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$21.50
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$30.72
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$26.11
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$21.50
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$30.72
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23.04
|
| Rate for Payer: SOMOS Essential |
$23.04
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$30.72
|
|
|
CHG ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION
|
Professional
|
Both
|
$399.53
|
|
|
Service Code
|
HCPCS 76982
|
| Min. Negotiated Rate |
$74.10 |
| Max. Negotiated Rate |
$238.19 |
| Rate for Payer: Cash Price |
$108.34
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$105.86
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$95.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$95.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$100.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$105.86
|
| Rate for Payer: Fidelis Qualified Health Plan |
$100.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$105.86
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$105.86
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$79.39
|
| Rate for Payer: Healthfirst Commercial |
$105.86
|
| Rate for Payer: Healthfirst Essential Plan |
$238.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$100.57
|
| Rate for Payer: Healthfirst QHP |
$105.86
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$74.10
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$105.86
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$89.98
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$74.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$105.86
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$79.39
|
| Rate for Payer: SOMOS Essential |
$79.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$105.86
|
|
