|
CHG RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY
|
Professional
|
$134.54
|
|
|
Service Code
|
HCPCS 74248 26
|
| Min. Negotiated Rate |
$26.91 |
| Max. Negotiated Rate |
$265.76 |
| Rate for Payer: Cash Price |
$36.34
|
| Rate for Payer: Cash Price |
$36.34
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$34.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$34.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$36.52
|
| Rate for Payer: Fidelis Medicare Advantage |
$38.44
|
| Rate for Payer: Fidelis Qualified Health Plan |
$36.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$38.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$38.44
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$28.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$36.52
|
| Rate for Payer: Healthfirst QHP |
$38.44
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$26.91
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$38.44
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$32.67
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$26.91
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$38.44
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$100.90
|
| Rate for Payer: SOMOS Essential |
$100.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$38.44
|
|
|
CHG RADIOPHARMACEUTICAL DACRYOCYSTOGRAPHY
|
Professional
|
$534.21
|
|
|
Service Code
|
HCPCS 78660 TC
|
| Min. Negotiated Rate |
$16.41 |
| Max. Negotiated Rate |
$462.19 |
| Rate for Payer: Cash Price |
$132.96
|
| Rate for Payer: Cash Price |
$132.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$137.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$137.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$145.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$152.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$145.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$152.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$152.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$114.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$145.00
|
| Rate for Payer: Healthfirst QHP |
$152.63
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$106.84
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$152.63
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$129.74
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$106.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$152.63
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$400.66
|
| Rate for Payer: SOMOS Essential |
$400.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$152.63
|
|
|
CHG RADIOPHARMACEUTICAL DACRYOCYSTOGRAPHY
|
Professional
|
$82.04
|
|
|
Service Code
|
HCPCS 78660 26
|
| Min. Negotiated Rate |
$16.41 |
| Max. Negotiated Rate |
$462.19 |
| Rate for Payer: Cash Price |
$22.25
|
| Rate for Payer: Cash Price |
$22.25
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21.10
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$21.10
|
| Rate for Payer: Fidelis Essential Plan QHP |
$22.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$23.44
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$23.44
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22.27
|
| Rate for Payer: Healthfirst QHP |
$23.44
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$16.41
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$23.44
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$19.92
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$16.41
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$23.44
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$61.53
|
| Rate for Payer: SOMOS Essential |
$61.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$23.44
|
|
|
CHG RADIOPHARMACEUTICAL DACRYOCYSTOGRAPHY
|
Professional
|
$616.25
|
|
|
Service Code
|
HCPCS 78660
|
| Min. Negotiated Rate |
$16.41 |
| Max. Negotiated Rate |
$462.19 |
| Rate for Payer: Cash Price |
$155.21
|
| Rate for Payer: Cash Price |
$155.21
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$158.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$158.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$167.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$176.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$167.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$176.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$176.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$132.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$167.27
|
| Rate for Payer: Healthfirst QHP |
$176.07
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$123.25
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$176.07
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$149.66
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$123.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$176.07
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$462.19
|
| Rate for Payer: SOMOS Essential |
$462.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$176.07
|
|
|
CHG RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA
|
Professional
|
$393.40
|
|
|
Service Code
|
HCPCS 78835
|
| Min. Negotiated Rate |
$16.89 |
| Max. Negotiated Rate |
$295.05 |
| Rate for Payer: Cash Price |
$103.53
|
| Rate for Payer: Cash Price |
$103.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$101.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$101.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$106.78
|
| Rate for Payer: Fidelis Medicare Advantage |
$112.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$106.78
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$112.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$112.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$84.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$106.78
|
| Rate for Payer: Healthfirst QHP |
$112.40
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$78.68
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$112.40
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$95.54
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$78.68
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$112.40
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$295.05
|
| Rate for Payer: SOMOS Essential |
$295.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$112.40
|
|
|
CHG RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA
|
Professional
|
$84.46
|
|
|
Service Code
|
HCPCS 78835 26
|
| Min. Negotiated Rate |
$16.89 |
| Max. Negotiated Rate |
$295.05 |
| Rate for Payer: Cash Price |
$22.75
|
| Rate for Payer: Cash Price |
$22.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21.72
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$21.72
|
| Rate for Payer: Fidelis Essential Plan QHP |
$22.92
|
| Rate for Payer: Fidelis Medicare Advantage |
$24.13
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22.92
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$24.13
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$24.13
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$18.10
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22.92
|
| Rate for Payer: Healthfirst QHP |
$24.13
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$16.89
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$24.13
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$20.51
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$16.89
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$24.13
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$63.34
|
| Rate for Payer: SOMOS Essential |
$63.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$24.13
|
|
|
CHG RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA
|
Professional
|
$308.91
|
|
|
Service Code
|
HCPCS 78835 TC
|
| Min. Negotiated Rate |
$16.89 |
| Max. Negotiated Rate |
$295.05 |
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$79.43
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$79.43
|
| Rate for Payer: Fidelis Essential Plan QHP |
$83.85
|
| Rate for Payer: Fidelis Medicare Advantage |
$88.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$83.85
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$88.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$88.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$66.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$83.85
|
| Rate for Payer: Healthfirst QHP |
$88.26
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$61.78
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$88.26
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$75.02
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$61.78
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$88.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$231.68
|
| Rate for Payer: SOMOS Essential |
$231.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$88.26
|
|
|
CHG RED CELL SURVIVAL STUDY
|
Professional
|
$528.26
|
|
|
Service Code
|
HCPCS 78130
|
| Min. Negotiated Rate |
$18.70 |
| Max. Negotiated Rate |
$396.20 |
| Rate for Payer: Cash Price |
$145.10
|
| Rate for Payer: Cash Price |
$145.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$135.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$135.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$143.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$150.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$143.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$150.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$150.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$113.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$143.38
|
| Rate for Payer: Healthfirst QHP |
$150.93
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$105.65
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$150.93
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$128.29
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$105.65
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$150.93
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$396.20
|
| Rate for Payer: SOMOS Essential |
$396.20
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$150.93
|
|
|
CHG RED CELL SURVIVAL STUDY
|
Professional
|
$93.52
|
|
|
Service Code
|
HCPCS 78130 26
|
| Min. Negotiated Rate |
$18.70 |
| Max. Negotiated Rate |
$396.20 |
| Rate for Payer: Cash Price |
$25.83
|
| Rate for Payer: Cash Price |
$25.83
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$24.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$24.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$25.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$26.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$25.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$20.04
|
| Rate for Payer: Healthfirst Medicare Advantage |
$25.38
|
| Rate for Payer: Healthfirst QHP |
$26.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$18.70
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$26.72
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$22.71
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$18.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26.72
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$70.14
|
| Rate for Payer: SOMOS Essential |
$70.14
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26.72
|
|
|
CHG RED CELL SURVIVAL STUDY
|
Professional
|
$434.74
|
|
|
Service Code
|
HCPCS 78130 TC
|
| Min. Negotiated Rate |
$18.70 |
| Max. Negotiated Rate |
$396.20 |
| Rate for Payer: Cash Price |
$119.28
|
| Rate for Payer: Cash Price |
$119.28
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$111.79
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$111.79
|
| Rate for Payer: Fidelis Essential Plan QHP |
$118.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$124.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$118.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$124.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$124.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$93.16
|
| Rate for Payer: Healthfirst Medicare Advantage |
$118.00
|
| Rate for Payer: Healthfirst QHP |
$124.21
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$86.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$124.21
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$105.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$86.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$124.21
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$326.06
|
| Rate for Payer: SOMOS Essential |
$326.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$124.21
|
|
|
CHG RED CELL VOLUME DETERMINATION SPX 1 SAMPLING
|
Professional
|
$37.31
|
|
|
Service Code
|
HCPCS 78120 26
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$229.16 |
| Rate for Payer: Cash Price |
$10.22
|
| Rate for Payer: Cash Price |
$10.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$9.59
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.59
|
| Rate for Payer: Fidelis Essential Plan QHP |
$10.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$10.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$10.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10.66
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$8.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$10.13
|
| Rate for Payer: Healthfirst QHP |
$10.66
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$7.46
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$10.66
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$9.06
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$7.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$10.66
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$27.98
|
| Rate for Payer: SOMOS Essential |
$27.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$10.66
|
|
|
CHG RED CELL VOLUME DETERMINATION SPX 1 SAMPLING
|
Professional
|
$305.55
|
|
|
Service Code
|
HCPCS 78120
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$229.16 |
| Rate for Payer: Cash Price |
$83.45
|
| Rate for Payer: Cash Price |
$83.45
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$78.57
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$78.57
|
| Rate for Payer: Fidelis Essential Plan QHP |
$82.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$87.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$82.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$87.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$87.30
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$65.48
|
| Rate for Payer: Healthfirst Medicare Advantage |
$82.94
|
| Rate for Payer: Healthfirst QHP |
$87.30
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$61.11
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$87.30
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$74.20
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$61.11
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$87.30
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$229.16
|
| Rate for Payer: SOMOS Essential |
$229.16
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$87.30
|
|
|
CHG RED CELL VOLUME DETERMINATION SPX 1 SAMPLING
|
Professional
|
$268.24
|
|
|
Service Code
|
HCPCS 78120 TC
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$229.16 |
| Rate for Payer: Cash Price |
$73.23
|
| Rate for Payer: Cash Price |
$73.23
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$68.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$68.98
|
| Rate for Payer: Fidelis Essential Plan QHP |
$72.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$76.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$72.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$76.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$76.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$57.48
|
| Rate for Payer: Healthfirst Medicare Advantage |
$72.81
|
| Rate for Payer: Healthfirst QHP |
$76.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$53.65
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$76.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$65.14
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$53.65
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$76.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$201.18
|
| Rate for Payer: SOMOS Essential |
$201.18
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$76.64
|
|
|
CHG RED CELL VOLUME DETERMINATION SPX MULT SAMPLINGS
|
Professional
|
$50.02
|
|
|
Service Code
|
HCPCS 78121 26
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$248.41 |
| Rate for Payer: Cash Price |
$13.75
|
| Rate for Payer: Cash Price |
$13.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$12.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$12.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$13.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$14.29
|
| Rate for Payer: Fidelis Qualified Health Plan |
$13.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.29
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$10.72
|
| Rate for Payer: Healthfirst Medicare Advantage |
$13.58
|
| Rate for Payer: Healthfirst QHP |
$14.29
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$10.00
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$14.29
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$12.15
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$10.00
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$14.29
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$37.52
|
| Rate for Payer: SOMOS Essential |
$37.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$14.29
|
|
|
CHG RED CELL VOLUME DETERMINATION SPX MULT SAMPLINGS
|
Professional
|
$331.21
|
|
|
Service Code
|
HCPCS 78121
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$248.41 |
| Rate for Payer: Cash Price |
$90.52
|
| Rate for Payer: Cash Price |
$90.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$85.17
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$85.17
|
| Rate for Payer: Fidelis Essential Plan QHP |
$89.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$94.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$89.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$94.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$94.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$70.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$89.90
|
| Rate for Payer: Healthfirst QHP |
$94.63
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$66.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$94.63
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$80.44
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$66.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$94.63
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$248.41
|
| Rate for Payer: SOMOS Essential |
$248.41
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$94.63
|
|
|
CHG RED CELL VOLUME DETERMINATION SPX MULT SAMPLINGS
|
Professional
|
$281.19
|
|
|
Service Code
|
HCPCS 78121 TC
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$248.41 |
| Rate for Payer: Cash Price |
$76.77
|
| Rate for Payer: Cash Price |
$76.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$72.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$72.31
|
| Rate for Payer: Fidelis Essential Plan QHP |
$76.32
|
| Rate for Payer: Fidelis Medicare Advantage |
$80.34
|
| Rate for Payer: Fidelis Qualified Health Plan |
$76.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$80.34
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$80.34
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$60.26
|
| Rate for Payer: Healthfirst Medicare Advantage |
$76.32
|
| Rate for Payer: Healthfirst QHP |
$80.34
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$56.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$80.34
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$68.29
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$56.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$80.34
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$210.89
|
| Rate for Payer: SOMOS Essential |
$210.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$80.34
|
|
|
CHG RESPIRATORY MOTION MANAGEMENT SIMULATION
|
Professional
|
$1,333.43
|
|
|
Service Code
|
HCPCS 77293 TC
|
| Min. Negotiated Rate |
$84.38 |
| Max. Negotiated Rate |
$1,316.49 |
| Rate for Payer: Cash Price |
$359.05
|
| Rate for Payer: Cash Price |
$359.05
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$342.88
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$342.88
|
| Rate for Payer: Fidelis Essential Plan QHP |
$361.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$380.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$361.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$380.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$380.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$285.74
|
| Rate for Payer: Healthfirst Medicare Advantage |
$361.93
|
| Rate for Payer: Healthfirst QHP |
$380.98
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$266.69
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$380.98
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$323.83
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$266.69
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$380.98
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,000.07
|
| Rate for Payer: SOMOS Essential |
$1,000.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$380.98
|
|
|
CHG RESPIRATORY MOTION MANAGEMENT SIMULATION
|
Professional
|
$421.89
|
|
|
Service Code
|
HCPCS 77293 26
|
| Min. Negotiated Rate |
$84.38 |
| Max. Negotiated Rate |
$1,316.49 |
| Rate for Payer: Cash Price |
$116.01
|
| Rate for Payer: Cash Price |
$116.01
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$108.49
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$108.49
|
| Rate for Payer: Fidelis Essential Plan QHP |
$114.51
|
| Rate for Payer: Fidelis Medicare Advantage |
$120.54
|
| Rate for Payer: Fidelis Qualified Health Plan |
$114.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$120.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$120.54
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$90.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$114.51
|
| Rate for Payer: Healthfirst QHP |
$120.54
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$84.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$120.54
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$102.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$84.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$120.54
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$316.42
|
| Rate for Payer: SOMOS Essential |
$316.42
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$120.54
|
|
|
CHG RESPIRATORY MOTION MANAGEMENT SIMULATION
|
Professional
|
$1,755.32
|
|
|
Service Code
|
HCPCS 77293
|
| Min. Negotiated Rate |
$84.38 |
| Max. Negotiated Rate |
$1,316.49 |
| Rate for Payer: Cash Price |
$475.06
|
| Rate for Payer: Cash Price |
$475.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$451.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$451.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$476.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$501.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$476.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$501.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$501.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$376.14
|
| Rate for Payer: Healthfirst Medicare Advantage |
$476.44
|
| Rate for Payer: Healthfirst QHP |
$501.52
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$351.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$501.52
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$426.29
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$351.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$501.52
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,316.49
|
| Rate for Payer: SOMOS Essential |
$1,316.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$501.52
|
|
|
CHG RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I
|
Professional
|
$670.53
|
|
|
Service Code
|
HCPCS 74235
|
| Min. Negotiated Rate |
$45.74 |
| Max. Negotiated Rate |
$502.90 |
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$502.90
|
| Rate for Payer: SOMOS Essential |
$502.90
|
|
|
CHG RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I
|
Professional
|
$228.73
|
|
|
Service Code
|
HCPCS 74235 26
|
| Min. Negotiated Rate |
$45.74 |
| Max. Negotiated Rate |
$502.90 |
| Rate for Payer: Cash Price |
$61.76
|
| Rate for Payer: Cash Price |
$61.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$58.82
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$58.82
|
| Rate for Payer: Fidelis Essential Plan QHP |
$62.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$65.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$62.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$65.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$65.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$49.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$62.08
|
| Rate for Payer: Healthfirst QHP |
$65.35
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$45.74
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$65.35
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$55.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$45.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$65.35
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$171.55
|
| Rate for Payer: SOMOS Essential |
$171.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$65.35
|
|
|
CHG RMVL FB ESOPHAGEAL W/USE BALLOON CATH RS&I
|
Professional
|
$441.81
|
|
|
Service Code
|
HCPCS 74235 TC
|
| Min. Negotiated Rate |
$45.74 |
| Max. Negotiated Rate |
$502.90 |
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$331.36
|
| Rate for Payer: SOMOS Essential |
$331.36
|
|
|
CHG RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING
|
Professional
|
$122.75
|
|
|
Service Code
|
HCPCS 78800 26
|
| Min. Negotiated Rate |
$24.55 |
| Max. Negotiated Rate |
$758.99 |
| Rate for Payer: Cash Price |
$34.32
|
| Rate for Payer: Cash Price |
$34.32
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$31.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$31.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$33.32
|
| Rate for Payer: Fidelis Medicare Advantage |
$35.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$33.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$35.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$35.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$33.32
|
| Rate for Payer: Healthfirst QHP |
$35.07
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$24.55
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$35.07
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$29.81
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$24.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$35.07
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$92.06
|
| Rate for Payer: SOMOS Essential |
$92.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$35.07
|
|
|
CHG RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING
|
Professional
|
$889.25
|
|
|
Service Code
|
HCPCS 78800 TC
|
| Min. Negotiated Rate |
$24.55 |
| Max. Negotiated Rate |
$758.99 |
| Rate for Payer: Cash Price |
$239.05
|
| Rate for Payer: Cash Price |
$239.05
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$228.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$228.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$241.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$254.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$241.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$254.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$254.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$190.55
|
| Rate for Payer: Healthfirst Medicare Advantage |
$241.37
|
| Rate for Payer: Healthfirst QHP |
$254.07
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$177.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$254.07
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$215.96
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$177.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$254.07
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$666.94
|
| Rate for Payer: SOMOS Essential |
$666.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$254.07
|
|
|
CHG RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING
|
Professional
|
$1,011.99
|
|
|
Service Code
|
HCPCS 78800
|
| Min. Negotiated Rate |
$24.55 |
| Max. Negotiated Rate |
$758.99 |
| Rate for Payer: Cash Price |
$273.37
|
| Rate for Payer: Cash Price |
$273.37
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$260.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$260.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$274.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$289.14
|
| Rate for Payer: Fidelis Qualified Health Plan |
$274.68
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$289.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$289.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$216.86
|
| Rate for Payer: Healthfirst Medicare Advantage |
$274.68
|
| Rate for Payer: Healthfirst QHP |
$289.14
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$202.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$289.14
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$245.77
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$202.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$289.14
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$758.99
|
| Rate for Payer: SOMOS Essential |
$758.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$289.14
|
|
