|
CHG CT UPPER EXTREMITY W/CONTRAST MATERIAL
|
Professional
|
$222.08
|
|
|
Service Code
|
HCPCS 73201 26
|
| Min. Negotiated Rate |
$44.42 |
| Max. Negotiated Rate |
$668.74 |
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$57.10
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$57.10
|
| Rate for Payer: Fidelis Essential Plan QHP |
$60.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$63.45
|
| Rate for Payer: Fidelis Qualified Health Plan |
$60.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$63.45
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$63.45
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$47.59
|
| Rate for Payer: Healthfirst Medicare Advantage |
$60.28
|
| Rate for Payer: Healthfirst QHP |
$63.45
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$44.42
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$63.45
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$53.93
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$44.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$63.45
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$166.56
|
| Rate for Payer: SOMOS Essential |
$166.56
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$63.45
|
|
|
CHG CT UPPER EXTREMITY W/O CONTRAST MATERIAL
|
Professional
|
$187.95
|
|
|
Service Code
|
HCPCS 73200 26
|
| Min. Negotiated Rate |
$37.59 |
| Max. Negotiated Rate |
$482.61 |
| Rate for Payer: Cash Price |
$51.75
|
| Rate for Payer: Cash Price |
$51.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$48.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$48.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$51.02
|
| Rate for Payer: Fidelis Medicare Advantage |
$53.70
|
| Rate for Payer: Fidelis Qualified Health Plan |
$51.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$53.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$53.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$40.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$51.02
|
| Rate for Payer: Healthfirst QHP |
$53.70
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$37.59
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$53.70
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$45.64
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$37.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$53.70
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$140.96
|
| Rate for Payer: SOMOS Essential |
$140.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$53.70
|
|
|
CHG CT UPPER EXTREMITY W/O CONTRAST MATERIAL
|
Professional
|
$643.48
|
|
|
Service Code
|
HCPCS 73200
|
| Min. Negotiated Rate |
$37.59 |
| Max. Negotiated Rate |
$482.61 |
| Rate for Payer: Cash Price |
$191.87
|
| Rate for Payer: Cash Price |
$191.87
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$182.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$182.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$193.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$203.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$193.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$203.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$203.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$152.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$193.00
|
| Rate for Payer: Healthfirst QHP |
$203.16
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$142.21
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$203.16
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$172.69
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$142.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$203.16
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$482.61
|
| Rate for Payer: SOMOS Essential |
$482.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$203.16
|
|
|
CHG CT UPPER EXTREMITY W/O CONTRAST MATERIAL
|
Professional
|
$455.56
|
|
|
Service Code
|
HCPCS 73200 TC
|
| Min. Negotiated Rate |
$37.59 |
| Max. Negotiated Rate |
$482.61 |
| Rate for Payer: Cash Price |
$140.12
|
| Rate for Payer: Cash Price |
$140.12
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$134.51
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$134.51
|
| Rate for Payer: Fidelis Essential Plan QHP |
$141.99
|
| Rate for Payer: Fidelis Medicare Advantage |
$149.46
|
| Rate for Payer: Fidelis Qualified Health Plan |
$141.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$149.46
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$149.46
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$112.10
|
| Rate for Payer: Healthfirst Medicare Advantage |
$141.99
|
| Rate for Payer: Healthfirst QHP |
$149.46
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$104.62
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$149.46
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$127.04
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$104.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$149.46
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$341.67
|
| Rate for Payer: SOMOS Essential |
$341.67
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$149.46
|
|
|
CHG CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL
|
Professional
|
$999.81
|
|
|
Service Code
|
HCPCS 73202
|
| Min. Negotiated Rate |
$46.49 |
| Max. Negotiated Rate |
$749.86 |
| Rate for Payer: Cash Price |
$297.45
|
| Rate for Payer: Cash Price |
$297.45
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$284.81
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$284.81
|
| Rate for Payer: Fidelis Essential Plan QHP |
$300.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$316.46
|
| Rate for Payer: Fidelis Qualified Health Plan |
$300.64
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$316.46
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$316.46
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$237.34
|
| Rate for Payer: Healthfirst Medicare Advantage |
$300.64
|
| Rate for Payer: Healthfirst QHP |
$316.46
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$221.52
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$316.46
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$268.99
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$221.52
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$316.46
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$749.86
|
| Rate for Payer: SOMOS Essential |
$749.86
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$316.46
|
|
|
CHG CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL
|
Professional
|
$232.47
|
|
|
Service Code
|
HCPCS 73202 26
|
| Min. Negotiated Rate |
$46.49 |
| Max. Negotiated Rate |
$749.86 |
| Rate for Payer: Cash Price |
$62.80
|
| Rate for Payer: Cash Price |
$62.80
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$59.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$59.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$63.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$66.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$63.10
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$66.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$66.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$49.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$63.10
|
| Rate for Payer: Healthfirst QHP |
$66.42
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$46.49
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$66.42
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$56.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$46.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$66.42
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$174.35
|
| Rate for Payer: SOMOS Essential |
$174.35
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$66.42
|
|
|
CHG CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL
|
Professional
|
$767.34
|
|
|
Service Code
|
HCPCS 73202 TC
|
| Min. Negotiated Rate |
$46.49 |
| Max. Negotiated Rate |
$749.86 |
| Rate for Payer: Cash Price |
$234.65
|
| Rate for Payer: Cash Price |
$234.65
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$225.04
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$225.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$237.54
|
| Rate for Payer: Fidelis Medicare Advantage |
$250.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$237.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$250.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$250.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$187.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$237.54
|
| Rate for Payer: Healthfirst QHP |
$250.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$175.03
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$250.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$212.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$175.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$250.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$575.50
|
| Rate for Payer: SOMOS Essential |
$575.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$250.04
|
|
|
CHG CUL BACT AEROBIC ADDL METHS DEFINITIVE EA ISOL
|
Professional
|
$32.32
|
|
|
Service Code
|
HCPCS 87077
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$24.24 |
| Rate for Payer: Cash Price |
$8.08
|
| Rate for Payer: Cash Price |
$8.08
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$7.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$7.68
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$6.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$7.68
|
| Rate for Payer: Healthfirst QHP |
$8.08
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$5.66
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$8.08
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$6.87
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$5.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.08
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24.24
|
| Rate for Payer: SOMOS Essential |
$24.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.08
|
|
|
CHG CYSTOGRAPHY MINIMUM 3 VIEWS RS&I
|
Professional
|
$61.36
|
|
|
Service Code
|
HCPCS 74430 26
|
| Min. Negotiated Rate |
$12.27 |
| Max. Negotiated Rate |
$132.17 |
| Rate for Payer: Cash Price |
$16.73
|
| Rate for Payer: Cash Price |
$16.73
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$15.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$15.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$16.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$17.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$16.65
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$17.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$13.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$16.65
|
| Rate for Payer: Healthfirst QHP |
$17.53
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$12.27
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$17.53
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$14.90
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$12.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17.53
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$46.02
|
| Rate for Payer: SOMOS Essential |
$46.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17.53
|
|
|
CHG CYSTOGRAPHY MINIMUM 3 VIEWS RS&I
|
Professional
|
$176.23
|
|
|
Service Code
|
HCPCS 74430
|
| Min. Negotiated Rate |
$12.27 |
| Max. Negotiated Rate |
$132.17 |
| Rate for Payer: Cash Price |
$48.01
|
| Rate for Payer: Cash Price |
$48.01
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$45.32
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$45.32
|
| Rate for Payer: Fidelis Essential Plan QHP |
$47.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$50.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$47.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$50.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$50.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$37.76
|
| Rate for Payer: Healthfirst Medicare Advantage |
$47.83
|
| Rate for Payer: Healthfirst QHP |
$50.35
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$35.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$50.35
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$42.80
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$35.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$50.35
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$132.17
|
| Rate for Payer: SOMOS Essential |
$132.17
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$50.35
|
|
|
CHG CYSTOGRAPHY MINIMUM 3 VIEWS RS&I
|
Professional
|
$114.87
|
|
|
Service Code
|
HCPCS 74430 TC
|
| Min. Negotiated Rate |
$12.27 |
| Max. Negotiated Rate |
$132.17 |
| Rate for Payer: Cash Price |
$31.27
|
| Rate for Payer: Cash Price |
$31.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$29.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$29.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$31.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$32.82
|
| Rate for Payer: Fidelis Qualified Health Plan |
$31.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$32.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$32.82
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$31.18
|
| Rate for Payer: Healthfirst QHP |
$32.82
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$22.97
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$32.82
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$27.90
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$22.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$32.82
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$86.15
|
| Rate for Payer: SOMOS Essential |
$86.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$32.82
|
|
|
CHG CYTOPATHOLOGY FORENSIC
|
Professional
|
$54.01
|
|
|
Service Code
|
HCPCS 88125 26
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$88.91 |
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$13.89
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$13.89
|
| Rate for Payer: Fidelis Essential Plan QHP |
$14.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$15.43
|
| Rate for Payer: Fidelis Qualified Health Plan |
$14.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$15.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$15.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$11.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14.66
|
| Rate for Payer: Healthfirst QHP |
$15.43
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$10.80
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$15.43
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$13.12
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$10.80
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$15.43
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$40.51
|
| Rate for Payer: SOMOS Essential |
$40.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$15.43
|
|
|
CHG CYTOPATHOLOGY FORENSIC
|
Professional
|
$64.54
|
|
|
Service Code
|
HCPCS 88125 TC
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$88.91 |
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$16.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$16.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$17.52
|
| Rate for Payer: Fidelis Medicare Advantage |
$18.44
|
| Rate for Payer: Fidelis Qualified Health Plan |
$17.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$18.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$18.44
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$13.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17.52
|
| Rate for Payer: Healthfirst QHP |
$18.44
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$12.91
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$18.44
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$15.67
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$12.91
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$18.44
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$48.40
|
| Rate for Payer: SOMOS Essential |
$48.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$18.44
|
|
|
CHG CYTOPATHOLOGY FORENSIC
|
Professional
|
$118.55
|
|
|
Service Code
|
HCPCS 88125
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$88.91 |
| Rate for Payer: Cash Price |
$33.11
|
| Rate for Payer: Cash Price |
$33.11
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$30.48
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$30.48
|
| Rate for Payer: Fidelis Essential Plan QHP |
$32.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$33.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$32.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$33.87
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$33.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$32.18
|
| Rate for Payer: Healthfirst QHP |
$33.87
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$23.71
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$33.87
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$28.79
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$23.71
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$33.87
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$88.91
|
| Rate for Payer: SOMOS Essential |
$88.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$33.87
|
|
|
CHG CYTP CERVICAL/VAGINAL REQ INTERP PHYSICIAN
|
Professional
|
$94.26
|
|
|
Service Code
|
HCPCS 88141
|
| Min. Negotiated Rate |
$18.85 |
| Max. Negotiated Rate |
$70.70 |
| Rate for Payer: Cash Price |
$27.37
|
| Rate for Payer: Cash Price |
$27.37
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$24.24
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$24.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$25.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$26.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$25.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$25.58
|
| Rate for Payer: Healthfirst QHP |
$26.93
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$18.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$26.93
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$22.89
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$18.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26.93
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$70.70
|
| Rate for Payer: SOMOS Essential |
$70.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26.93
|
|
|
CHG CYTP CONCENTRATION SMEARS & INTERPRETATION
|
Professional
|
$86.59
|
|
|
Service Code
|
HCPCS 88108 26
|
| Min. Negotiated Rate |
$17.32 |
| Max. Negotiated Rate |
$208.24 |
| Rate for Payer: Cash Price |
$23.83
|
| Rate for Payer: Cash Price |
$23.83
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$22.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$22.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$23.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$24.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$23.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$24.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$24.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$23.50
|
| Rate for Payer: Healthfirst QHP |
$24.74
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$17.32
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$24.74
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$21.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$17.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$24.74
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$64.94
|
| Rate for Payer: SOMOS Essential |
$64.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$24.74
|
|
|
CHG CYTP CONCENTRATION SMEARS & INTERPRETATION
|
Professional
|
$277.66
|
|
|
Service Code
|
HCPCS 88108
|
| Min. Negotiated Rate |
$17.32 |
| Max. Negotiated Rate |
$208.24 |
| Rate for Payer: Cash Price |
$79.46
|
| Rate for Payer: Cash Price |
$79.46
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$71.40
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$71.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$75.36
|
| Rate for Payer: Fidelis Medicare Advantage |
$79.33
|
| Rate for Payer: Fidelis Qualified Health Plan |
$75.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$79.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$79.33
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$59.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$75.36
|
| Rate for Payer: Healthfirst QHP |
$79.33
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$55.53
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$79.33
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$67.43
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$55.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$79.33
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$208.24
|
| Rate for Payer: SOMOS Essential |
$208.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$79.33
|
|
|
CHG CYTP CONCENTRATION SMEARS & INTERPRETATION
|
Professional
|
$191.07
|
|
|
Service Code
|
HCPCS 88108 TC
|
| Min. Negotiated Rate |
$17.32 |
| Max. Negotiated Rate |
$208.24 |
| Rate for Payer: Cash Price |
$55.64
|
| Rate for Payer: Cash Price |
$55.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$49.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$49.13
|
| Rate for Payer: Fidelis Essential Plan QHP |
$51.86
|
| Rate for Payer: Fidelis Medicare Advantage |
$54.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$51.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$54.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$54.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$40.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$51.86
|
| Rate for Payer: Healthfirst QHP |
$54.59
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$38.21
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$54.59
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$46.40
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$38.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$54.59
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$143.30
|
| Rate for Payer: SOMOS Essential |
$143.30
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$54.59
|
|
|
CHG CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT
|
Professional
|
$404.81
|
|
|
Service Code
|
HCPCS 88173 TC
|
| Min. Negotiated Rate |
$53.74 |
| Max. Negotiated Rate |
$505.13 |
| Rate for Payer: Cash Price |
$118.58
|
| Rate for Payer: Cash Price |
$118.58
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$104.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$104.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$109.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$115.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$109.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$115.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$115.66
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$86.74
|
| Rate for Payer: Healthfirst Medicare Advantage |
$109.88
|
| Rate for Payer: Healthfirst QHP |
$115.66
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$80.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$115.66
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$98.31
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$80.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$115.66
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$303.61
|
| Rate for Payer: SOMOS Essential |
$303.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$115.66
|
|
|
CHG CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT
|
Professional
|
$673.51
|
|
|
Service Code
|
HCPCS 88173
|
| Min. Negotiated Rate |
$53.74 |
| Max. Negotiated Rate |
$505.13 |
| Rate for Payer: Cash Price |
$192.27
|
| Rate for Payer: Cash Price |
$192.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$173.19
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$173.19
|
| Rate for Payer: Fidelis Essential Plan QHP |
$182.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$192.43
|
| Rate for Payer: Fidelis Qualified Health Plan |
$182.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$192.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$192.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$144.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$182.81
|
| Rate for Payer: Healthfirst QHP |
$192.43
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$134.70
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$192.43
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$163.57
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$134.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$192.43
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$505.13
|
| Rate for Payer: SOMOS Essential |
$505.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$192.43
|
|
|
CHG CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT
|
Professional
|
$268.70
|
|
|
Service Code
|
HCPCS 88173 26
|
| Min. Negotiated Rate |
$53.74 |
| Max. Negotiated Rate |
$505.13 |
| Rate for Payer: Cash Price |
$73.69
|
| Rate for Payer: Cash Price |
$73.69
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$69.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$69.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$72.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$76.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$72.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$76.77
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$76.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$57.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$72.93
|
| Rate for Payer: Healthfirst QHP |
$76.77
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$53.74
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$76.77
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$65.25
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$53.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$76.77
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$201.52
|
| Rate for Payer: SOMOS Essential |
$201.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$76.77
|
|
|
CHG CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST
|
Professional
|
$90.44
|
|
|
Service Code
|
HCPCS 88172 TC
|
| Min. Negotiated Rate |
$18.09 |
| Max. Negotiated Rate |
$170.26 |
| Rate for Payer: Cash Price |
$25.77
|
| Rate for Payer: Cash Price |
$25.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.26
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$23.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$24.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$25.84
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$25.84
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$24.55
|
| Rate for Payer: Healthfirst QHP |
$25.84
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$18.09
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$25.84
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$21.96
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$18.09
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$25.84
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$67.83
|
| Rate for Payer: SOMOS Essential |
$67.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$25.84
|
|
|
CHG CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST
|
Professional
|
$136.61
|
|
|
Service Code
|
HCPCS 88172 26
|
| Min. Negotiated Rate |
$18.09 |
| Max. Negotiated Rate |
$170.26 |
| Rate for Payer: Cash Price |
$37.26
|
| Rate for Payer: Cash Price |
$37.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$35.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$35.13
|
| Rate for Payer: Fidelis Essential Plan QHP |
$37.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$39.03
|
| Rate for Payer: Fidelis Qualified Health Plan |
$37.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$39.03
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$39.03
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$37.08
|
| Rate for Payer: Healthfirst QHP |
$39.03
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$27.32
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$39.03
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$33.18
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$27.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$39.03
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$102.46
|
| Rate for Payer: SOMOS Essential |
$102.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$39.03
|
|
|
CHG CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST
|
Professional
|
$227.01
|
|
|
Service Code
|
HCPCS 88172
|
| Min. Negotiated Rate |
$18.09 |
| Max. Negotiated Rate |
$170.26 |
| Rate for Payer: Cash Price |
$63.03
|
| Rate for Payer: Cash Price |
$63.03
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$58.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$58.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$61.62
|
| Rate for Payer: Fidelis Medicare Advantage |
$64.86
|
| Rate for Payer: Fidelis Qualified Health Plan |
$61.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$64.86
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$64.86
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$48.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$61.62
|
| Rate for Payer: Healthfirst QHP |
$64.86
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$45.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$64.86
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$55.13
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$45.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$64.86
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$170.26
|
| Rate for Payer: SOMOS Essential |
$170.26
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$64.86
|
|
|
CHG CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL
|
Professional
|
$118.58
|
|
|
Service Code
|
HCPCS 88177
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$88.94 |
| Rate for Payer: Cash Price |
$32.95
|
| Rate for Payer: Cash Price |
$32.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$30.49
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$30.49
|
| Rate for Payer: Fidelis Essential Plan QHP |
$32.19
|
| Rate for Payer: Fidelis Medicare Advantage |
$33.88
|
| Rate for Payer: Fidelis Qualified Health Plan |
$32.19
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$33.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$33.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$32.19
|
| Rate for Payer: Healthfirst QHP |
$33.88
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$23.72
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$33.88
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$28.80
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$23.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$33.88
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$88.94
|
| Rate for Payer: SOMOS Essential |
$88.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$33.88
|
|
