|
CHG RADIOLOGIC EXAMINATION ANKLE 2 VIEWS
|
Professional
|
$32.83
|
|
|
Service Code
|
HCPCS 73600 26
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$105.40 |
| Rate for Payer: Cash Price |
$8.56
|
| Rate for Payer: Cash Price |
$8.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.44
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.91
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.38
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.38
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.38
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.04
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.91
|
| Rate for Payer: Healthfirst QHP |
$9.38
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$6.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$9.38
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$7.97
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$6.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.38
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24.62
|
| Rate for Payer: SOMOS Essential |
$24.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.38
|
|
|
CHG RADIOLOGIC EXAMINATION ANKLE 2 VIEWS
|
Professional
|
$107.66
|
|
|
Service Code
|
HCPCS 73600 TC
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$105.40 |
| Rate for Payer: Cash Price |
$29.31
|
| Rate for Payer: Cash Price |
$29.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$27.68
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$27.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$29.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$30.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$29.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.76
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$29.22
|
| Rate for Payer: Healthfirst QHP |
$30.76
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$21.53
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$30.76
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$26.15
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$21.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$30.76
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$80.74
|
| Rate for Payer: SOMOS Essential |
$80.74
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$30.76
|
|
|
CHG RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY
|
Professional
|
$35.35
|
|
|
Service Code
|
HCPCS 70030 26
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$105.10 |
| Rate for Payer: Cash Price |
$9.26
|
| Rate for Payer: Cash Price |
$9.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$9.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$9.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$10.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$9.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.60
|
| Rate for Payer: Healthfirst QHP |
$10.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$7.07
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$10.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$8.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$7.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$10.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26.51
|
| Rate for Payer: SOMOS Essential |
$26.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$10.10
|
|
|
CHG RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY
|
Professional
|
$140.14
|
|
|
Service Code
|
HCPCS 70030
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$105.10 |
| Rate for Payer: Cash Price |
$38.18
|
| Rate for Payer: Cash Price |
$38.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36.04
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$36.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$38.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$40.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$38.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$40.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$38.04
|
| Rate for Payer: Healthfirst QHP |
$40.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$28.03
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$40.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$34.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$28.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$40.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$105.10
|
| Rate for Payer: SOMOS Essential |
$105.10
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$40.04
|
|
|
CHG RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY
|
Professional
|
$104.79
|
|
|
Service Code
|
HCPCS 70030 TC
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$105.10 |
| Rate for Payer: Cash Price |
$28.92
|
| Rate for Payer: Cash Price |
$28.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$26.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$26.95
|
| Rate for Payer: Fidelis Essential Plan QHP |
$28.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$29.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$28.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$29.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$29.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$22.46
|
| Rate for Payer: Healthfirst Medicare Advantage |
$28.44
|
| Rate for Payer: Healthfirst QHP |
$29.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$20.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$29.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$25.45
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$20.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$29.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$78.59
|
| Rate for Payer: SOMOS Essential |
$78.59
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$29.94
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR 1 VIEW
|
Professional
|
$126.14
|
|
|
Service Code
|
HCPCS 73551
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$94.60 |
| Rate for Payer: Cash Price |
$34.34
|
| Rate for Payer: Cash Price |
$34.34
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$32.44
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$32.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$34.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$36.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$34.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$36.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$36.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$27.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$34.24
|
| Rate for Payer: Healthfirst QHP |
$36.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$25.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$36.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$30.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$25.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$36.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$94.60
|
| Rate for Payer: SOMOS Essential |
$94.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$36.04
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR 1 VIEW
|
Professional
|
$93.31
|
|
|
Service Code
|
HCPCS 73551 TC
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$94.60 |
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.99
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$23.99
|
| Rate for Payer: Fidelis Essential Plan QHP |
$25.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$26.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$25.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26.66
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$25.33
|
| Rate for Payer: Healthfirst QHP |
$26.66
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$18.66
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$26.66
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$22.66
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$18.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26.66
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$69.98
|
| Rate for Payer: SOMOS Essential |
$69.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26.66
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR 1 VIEW
|
Professional
|
$32.83
|
|
|
Service Code
|
HCPCS 73551 26
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$94.60 |
| Rate for Payer: Cash Price |
$8.96
|
| Rate for Payer: Cash Price |
$8.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.44
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.91
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.38
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.38
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.38
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.04
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.91
|
| Rate for Payer: Healthfirst QHP |
$9.38
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$6.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$9.38
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$7.97
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$6.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.38
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24.62
|
| Rate for Payer: SOMOS Essential |
$24.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.38
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS
|
Professional
|
$35.35
|
|
|
Service Code
|
HCPCS 73552 26
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$114.82 |
| Rate for Payer: Cash Price |
$9.65
|
| Rate for Payer: Cash Price |
$9.65
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$9.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$9.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$10.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$9.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.60
|
| Rate for Payer: Healthfirst QHP |
$10.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$7.07
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$10.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$8.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$7.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$10.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26.51
|
| Rate for Payer: SOMOS Essential |
$26.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$10.10
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS
|
Professional
|
$117.74
|
|
|
Service Code
|
HCPCS 73552 TC
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$114.82 |
| Rate for Payer: Cash Price |
$32.06
|
| Rate for Payer: Cash Price |
$32.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$30.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$30.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$31.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$33.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$31.96
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$33.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$33.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25.23
|
| Rate for Payer: Healthfirst Medicare Advantage |
$31.96
|
| Rate for Payer: Healthfirst QHP |
$33.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$23.55
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$33.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$28.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$23.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$33.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$88.30
|
| Rate for Payer: SOMOS Essential |
$88.30
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$33.64
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS
|
Professional
|
$153.09
|
|
|
Service Code
|
HCPCS 73552
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$114.82 |
| Rate for Payer: Cash Price |
$41.71
|
| Rate for Payer: Cash Price |
$41.71
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$39.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$39.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$41.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$43.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$41.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$43.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$43.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$32.80
|
| Rate for Payer: Healthfirst Medicare Advantage |
$41.55
|
| Rate for Payer: Healthfirst QHP |
$43.74
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$30.62
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$43.74
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$37.18
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$30.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$43.74
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$114.82
|
| Rate for Payer: SOMOS Essential |
$114.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$43.74
|
|
|
CHG RADIOLOGIC EXAMINATION FOOT 2 VIEWS
|
Professional
|
$91.88
|
|
|
Service Code
|
HCPCS 73620 TC
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$91.38 |
| Rate for Payer: Cash Price |
$25.38
|
| Rate for Payer: Cash Price |
$25.38
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.62
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$23.62
|
| Rate for Payer: Fidelis Essential Plan QHP |
$24.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$26.25
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26.25
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19.69
|
| Rate for Payer: Healthfirst Medicare Advantage |
$24.94
|
| Rate for Payer: Healthfirst QHP |
$26.25
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$18.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$26.25
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$22.31
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$18.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26.25
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$68.91
|
| Rate for Payer: SOMOS Essential |
$68.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26.25
|
|
|
CHG RADIOLOGIC EXAMINATION FOOT 2 VIEWS
|
Professional
|
$121.84
|
|
|
Service Code
|
HCPCS 73620
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$91.38 |
| Rate for Payer: Cash Price |
$33.55
|
| Rate for Payer: Cash Price |
$33.55
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$31.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$31.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$33.07
|
| Rate for Payer: Fidelis Medicare Advantage |
$34.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$33.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$34.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26.11
|
| Rate for Payer: Healthfirst Medicare Advantage |
$33.07
|
| Rate for Payer: Healthfirst QHP |
$34.81
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$24.37
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$34.81
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$29.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$24.37
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$34.81
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$91.38
|
| Rate for Payer: SOMOS Essential |
$91.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$34.81
|
|
|
CHG RADIOLOGIC EXAMINATION FOOT 2 VIEWS
|
Professional
|
$29.96
|
|
|
Service Code
|
HCPCS 73620 26
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$91.38 |
| Rate for Payer: Cash Price |
$8.17
|
| Rate for Payer: Cash Price |
$8.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$7.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$7.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$8.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$8.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$8.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$6.42
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.13
|
| Rate for Payer: Healthfirst QHP |
$8.56
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$5.99
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$8.56
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$7.28
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$5.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$8.56
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$22.47
|
| Rate for Payer: SOMOS Essential |
$22.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$8.56
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS
|
Professional
|
$114.87
|
|
|
Service Code
|
HCPCS 73560 TC
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$110.78 |
| 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 RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS
|
Professional
|
$32.83
|
|
|
Service Code
|
HCPCS 73560 26
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$110.78 |
| Rate for Payer: Cash Price |
$8.96
|
| Rate for Payer: Cash Price |
$8.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.44
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.91
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.38
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.38
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.38
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.04
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.91
|
| Rate for Payer: Healthfirst QHP |
$9.38
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$6.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$9.38
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$7.97
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$6.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.38
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24.62
|
| Rate for Payer: SOMOS Essential |
$24.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.38
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS
|
Professional
|
$147.70
|
|
|
Service Code
|
HCPCS 73560
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$110.78 |
| Rate for Payer: Cash Price |
$40.23
|
| Rate for Payer: Cash Price |
$40.23
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$37.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$37.98
|
| Rate for Payer: Fidelis Essential Plan QHP |
$40.09
|
| Rate for Payer: Fidelis Medicare Advantage |
$42.20
|
| Rate for Payer: Fidelis Qualified Health Plan |
$40.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$42.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$42.20
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$31.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$40.09
|
| Rate for Payer: Healthfirst QHP |
$42.20
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$29.54
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$42.20
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$35.87
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$29.54
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$42.20
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$110.78
|
| Rate for Payer: SOMOS Essential |
$110.78
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$42.20
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 3 VIEWS
|
Professional
|
$174.65
|
|
|
Service Code
|
HCPCS 73562
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$130.99 |
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$44.91
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$44.91
|
| Rate for Payer: Fidelis Essential Plan QHP |
$47.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$49.90
|
| Rate for Payer: Fidelis Qualified Health Plan |
$47.40
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$49.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$49.90
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$37.42
|
| Rate for Payer: Healthfirst Medicare Advantage |
$47.40
|
| Rate for Payer: Healthfirst QHP |
$49.90
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$34.93
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$49.90
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$42.42
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$34.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$49.90
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$130.99
|
| Rate for Payer: SOMOS Essential |
$130.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$49.90
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 3 VIEWS
|
Professional
|
$36.79
|
|
|
Service Code
|
HCPCS 73562 26
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$130.99 |
| Rate for Payer: Cash Price |
$10.05
|
| Rate for Payer: Cash Price |
$10.05
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$9.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$9.98
|
| Rate for Payer: Fidelis Medicare Advantage |
$10.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$9.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.88
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.98
|
| Rate for Payer: Healthfirst QHP |
$10.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$7.36
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$10.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$8.93
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$7.36
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$10.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$27.59
|
| Rate for Payer: SOMOS Essential |
$27.59
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$10.51
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 3 VIEWS
|
Professional
|
$137.87
|
|
|
Service Code
|
HCPCS 73562 TC
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$130.99 |
| Rate for Payer: Cash Price |
$37.95
|
| Rate for Payer: Cash Price |
$37.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$35.45
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$35.45
|
| Rate for Payer: Fidelis Essential Plan QHP |
$37.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$39.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$37.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$39.39
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$39.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29.54
|
| Rate for Payer: Healthfirst Medicare Advantage |
$37.42
|
| Rate for Payer: Healthfirst QHP |
$39.39
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$27.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$39.39
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$33.48
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$27.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$39.39
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$103.40
|
| Rate for Payer: SOMOS Essential |
$103.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$39.39
|
|
|
CHG RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS
|
Professional
|
$130.69
|
|
|
Service Code
|
HCPCS 70100 TC
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$124.51 |
| Rate for Payer: Cash Price |
$35.99
|
| Rate for Payer: Cash Price |
$35.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$33.61
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$33.61
|
| Rate for Payer: Fidelis Essential Plan QHP |
$35.47
|
| Rate for Payer: Fidelis Medicare Advantage |
$37.34
|
| Rate for Payer: Fidelis Qualified Health Plan |
$35.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$37.34
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$37.34
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$28.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$35.47
|
| Rate for Payer: Healthfirst QHP |
$37.34
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$26.14
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$37.34
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$31.74
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$26.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$37.34
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$98.02
|
| Rate for Payer: SOMOS Essential |
$98.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$37.34
|
|
|
CHG RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS
|
Professional
|
$35.35
|
|
|
Service Code
|
HCPCS 70100 26
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$124.51 |
| Rate for Payer: Cash Price |
$9.65
|
| Rate for Payer: Cash Price |
$9.65
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$9.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$9.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$10.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$9.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.60
|
| Rate for Payer: Healthfirst QHP |
$10.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$7.07
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$10.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$8.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$7.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$10.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26.51
|
| Rate for Payer: SOMOS Essential |
$26.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$10.10
|
|
|
CHG RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS
|
Professional
|
$166.01
|
|
|
Service Code
|
HCPCS 70100
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$124.51 |
| Rate for Payer: Cash Price |
$45.64
|
| Rate for Payer: Cash Price |
$45.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$42.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$42.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$45.06
|
| Rate for Payer: Fidelis Medicare Advantage |
$47.43
|
| Rate for Payer: Fidelis Qualified Health Plan |
$45.06
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$47.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$47.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$35.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$45.06
|
| Rate for Payer: Healthfirst QHP |
$47.43
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$33.20
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$47.43
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$40.32
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$33.20
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$47.43
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$124.51
|
| Rate for Payer: SOMOS Essential |
$124.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$47.43
|
|
|
CHG RADIOLOGIC EXAMINATION NECK SOFT TISSUE
|
Professional
|
$100.49
|
|
|
Service Code
|
HCPCS 70360 TC
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$101.88 |
| Rate for Payer: Cash Price |
$26.95
|
| Rate for Payer: Cash Price |
$26.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$25.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$25.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$27.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$28.71
|
| Rate for Payer: Fidelis Qualified Health Plan |
$27.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$28.71
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$28.71
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$21.53
|
| Rate for Payer: Healthfirst Medicare Advantage |
$27.27
|
| Rate for Payer: Healthfirst QHP |
$28.71
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$20.10
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$28.71
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$24.40
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$20.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$28.71
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$75.37
|
| Rate for Payer: SOMOS Essential |
$75.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$28.71
|
|
|
CHG RADIOLOGIC EXAMINATION NECK SOFT TISSUE
|
Professional
|
$135.84
|
|
|
Service Code
|
HCPCS 70360
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$101.88 |
| Rate for Payer: Cash Price |
$36.61
|
| Rate for Payer: Cash Price |
$36.61
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$34.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$34.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$36.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$38.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$36.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$38.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$38.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29.11
|
| Rate for Payer: Healthfirst Medicare Advantage |
$36.87
|
| Rate for Payer: Healthfirst QHP |
$38.81
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$27.17
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$38.81
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$32.99
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$27.17
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$38.81
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$101.88
|
| Rate for Payer: SOMOS Essential |
$101.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$38.81
|
|
