|
CHG VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I
|
Professional
|
$426.65
|
|
|
Service Code
|
HCPCS 75870 TC
|
| Min. Negotiated Rate |
$50.77 |
| Max. Negotiated Rate |
$510.38 |
| Rate for Payer: Cash Price |
$115.99
|
| Rate for Payer: Cash Price |
$115.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$109.71
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$109.71
|
| Rate for Payer: Fidelis Essential Plan QHP |
$115.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$121.90
|
| Rate for Payer: Fidelis Qualified Health Plan |
$115.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$121.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$121.90
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$91.42
|
| Rate for Payer: Healthfirst Medicare Advantage |
$115.80
|
| Rate for Payer: Healthfirst QHP |
$121.90
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$85.33
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$121.90
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$103.62
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$85.33
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$121.90
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$319.99
|
| Rate for Payer: SOMOS Essential |
$319.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$121.90
|
|
|
CHG VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I
|
Professional
|
$680.51
|
|
|
Service Code
|
HCPCS 75870
|
| Min. Negotiated Rate |
$50.77 |
| Max. Negotiated Rate |
$510.38 |
| Rate for Payer: Cash Price |
$182.49
|
| Rate for Payer: Cash Price |
$182.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$174.99
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$174.99
|
| Rate for Payer: Fidelis Essential Plan QHP |
$184.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$194.43
|
| Rate for Payer: Fidelis Qualified Health Plan |
$184.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$194.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$194.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$145.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$184.71
|
| Rate for Payer: Healthfirst QHP |
$194.43
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$136.10
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$194.43
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$165.27
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$136.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$194.43
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$510.38
|
| Rate for Payer: SOMOS Essential |
$510.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$194.43
|
|
|
CHG VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I
|
Professional
|
$253.86
|
|
|
Service Code
|
HCPCS 75870 26
|
| Min. Negotiated Rate |
$50.77 |
| Max. Negotiated Rate |
$510.38 |
| Rate for Payer: Cash Price |
$66.50
|
| Rate for Payer: Cash Price |
$66.50
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$65.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$65.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$68.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$72.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$68.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$72.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$72.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$54.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$68.90
|
| Rate for Payer: Healthfirst QHP |
$72.53
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$50.77
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$72.53
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$61.65
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$50.77
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$72.53
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$190.40
|
| Rate for Payer: SOMOS Essential |
$190.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$72.53
|
|
|
CHG VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I
|
Professional
|
$317.42
|
|
|
Service Code
|
HCPCS 75860 TC
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$403.41 |
| Rate for Payer: Cash Price |
$86.52
|
| Rate for Payer: Cash Price |
$86.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$81.62
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$81.62
|
| Rate for Payer: Fidelis Essential Plan QHP |
$86.16
|
| Rate for Payer: Fidelis Medicare Advantage |
$90.69
|
| Rate for Payer: Fidelis Qualified Health Plan |
$86.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$90.69
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$90.69
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$68.02
|
| Rate for Payer: Healthfirst Medicare Advantage |
$86.16
|
| Rate for Payer: Healthfirst QHP |
$90.69
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$63.48
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$90.69
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$77.09
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$63.48
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$90.69
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$238.06
|
| Rate for Payer: SOMOS Essential |
$238.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$90.69
|
|
|
CHG VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I
|
Professional
|
$537.88
|
|
|
Service Code
|
HCPCS 75860
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$403.41 |
| Rate for Payer: Cash Price |
$145.26
|
| Rate for Payer: Cash Price |
$145.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$138.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$138.31
|
| Rate for Payer: Fidelis Essential Plan QHP |
$146.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$153.68
|
| Rate for Payer: Fidelis Qualified Health Plan |
$146.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$153.68
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$153.68
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$115.26
|
| Rate for Payer: Healthfirst Medicare Advantage |
$146.00
|
| Rate for Payer: Healthfirst QHP |
$153.68
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$107.58
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$153.68
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$130.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$107.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$153.68
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$403.41
|
| Rate for Payer: SOMOS Essential |
$403.41
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$153.68
|
|
|
CHG VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I
|
Professional
|
$220.47
|
|
|
Service Code
|
HCPCS 75860 26
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$403.41 |
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$56.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$56.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$59.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$62.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$59.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$62.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$62.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$47.24
|
| Rate for Payer: Healthfirst Medicare Advantage |
$59.84
|
| Rate for Payer: Healthfirst QHP |
$62.99
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$44.09
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$62.99
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$53.54
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$44.09
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$62.99
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$165.35
|
| Rate for Payer: SOMOS Essential |
$165.35
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$62.99
|
|
|
CHG VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&
|
Professional
|
$343.28
|
|
|
Service Code
|
HCPCS 75893 TC
|
| Min. Negotiated Rate |
$20.31 |
| Max. Negotiated Rate |
$333.64 |
| Rate for Payer: Cash Price |
$94.77
|
| Rate for Payer: Cash Price |
$94.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$88.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$88.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$93.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$98.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$93.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$98.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$98.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$73.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$93.18
|
| Rate for Payer: Healthfirst QHP |
$98.08
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$68.66
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$98.08
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$83.37
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$68.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$98.08
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$257.46
|
| Rate for Payer: SOMOS Essential |
$257.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$98.08
|
|
|
CHG VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&
|
Professional
|
$101.57
|
|
|
Service Code
|
HCPCS 75893 26
|
| Min. Negotiated Rate |
$20.31 |
| Max. Negotiated Rate |
$333.64 |
| Rate for Payer: Cash Price |
$28.25
|
| Rate for Payer: Cash Price |
$28.25
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$26.12
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$26.12
|
| Rate for Payer: Fidelis Essential Plan QHP |
$27.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$29.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$27.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$29.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$29.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$21.76
|
| Rate for Payer: Healthfirst Medicare Advantage |
$27.57
|
| Rate for Payer: Healthfirst QHP |
$29.02
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$20.31
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$29.02
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$24.67
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$20.31
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$29.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$76.18
|
| Rate for Payer: SOMOS Essential |
$76.18
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$29.02
|
|
|
CHG VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&
|
Professional
|
$444.85
|
|
|
Service Code
|
HCPCS 75893
|
| Min. Negotiated Rate |
$20.31 |
| Max. Negotiated Rate |
$333.64 |
| Rate for Payer: Cash Price |
$123.02
|
| Rate for Payer: Cash Price |
$123.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$114.39
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$114.39
|
| Rate for Payer: Fidelis Essential Plan QHP |
$120.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$127.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$120.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$127.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$127.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$95.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$120.74
|
| Rate for Payer: Healthfirst QHP |
$127.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$88.97
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$127.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$108.04
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$88.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$127.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$333.64
|
| Rate for Payer: SOMOS Essential |
$333.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$127.10
|
|
|
CHG VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL
|
Professional
|
$171.12
|
|
|
Service Code
|
HCPCS 78458 26
|
| Min. Negotiated Rate |
$34.22 |
| Max. Negotiated Rate |
$626.01 |
| Rate for Payer: Cash Price |
$47.09
|
| Rate for Payer: Cash Price |
$47.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$44.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$44.00
|
| Rate for Payer: Fidelis Essential Plan QHP |
$46.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$48.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$46.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$48.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$48.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$36.67
|
| Rate for Payer: Healthfirst Medicare Advantage |
$46.45
|
| Rate for Payer: Healthfirst QHP |
$48.89
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$34.22
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$48.89
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$41.56
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$34.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$48.89
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$128.34
|
| Rate for Payer: SOMOS Essential |
$128.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$48.89
|
|
|
CHG VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL
|
Professional
|
$663.57
|
|
|
Service Code
|
HCPCS 78458 TC
|
| Min. Negotiated Rate |
$34.22 |
| Max. Negotiated Rate |
$626.01 |
| Rate for Payer: Cash Price |
$178.14
|
| Rate for Payer: Cash Price |
$178.14
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$170.63
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$170.63
|
| Rate for Payer: Fidelis Essential Plan QHP |
$180.11
|
| Rate for Payer: Fidelis Medicare Advantage |
$189.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$180.11
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$189.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$189.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$142.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$180.11
|
| Rate for Payer: Healthfirst QHP |
$189.59
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$132.71
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$189.59
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$161.15
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$132.71
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$189.59
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$497.68
|
| Rate for Payer: SOMOS Essential |
$497.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$189.59
|
|
|
CHG VENOUS THROMBOSIS IMAGING VENOGRAM BILATERAL
|
Professional
|
$834.68
|
|
|
Service Code
|
HCPCS 78458
|
| Min. Negotiated Rate |
$34.22 |
| Max. Negotiated Rate |
$626.01 |
| Rate for Payer: Cash Price |
$225.23
|
| Rate for Payer: Cash Price |
$225.23
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$214.63
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$214.63
|
| Rate for Payer: Fidelis Essential Plan QHP |
$226.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$238.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$226.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$238.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$238.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$178.86
|
| Rate for Payer: Healthfirst Medicare Advantage |
$226.56
|
| Rate for Payer: Healthfirst QHP |
$238.48
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$166.94
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$238.48
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$202.71
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$166.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$238.48
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$626.01
|
| Rate for Payer: SOMOS Essential |
$626.01
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$238.48
|
|
|
CHG VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL
|
Professional
|
$684.74
|
|
|
Service Code
|
HCPCS 78457
|
| Min. Negotiated Rate |
$31.55 |
| Max. Negotiated Rate |
$513.56 |
| Rate for Payer: Cash Price |
$183.11
|
| Rate for Payer: Cash Price |
$183.11
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$176.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$176.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$185.86
|
| Rate for Payer: Fidelis Medicare Advantage |
$195.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$185.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$195.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$195.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$146.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$185.86
|
| Rate for Payer: Healthfirst QHP |
$195.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$136.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$195.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$166.29
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$136.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$195.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$513.56
|
| Rate for Payer: SOMOS Essential |
$513.56
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$195.64
|
|
|
CHG VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL
|
Professional
|
$157.75
|
|
|
Service Code
|
HCPCS 78457 26
|
| Min. Negotiated Rate |
$31.55 |
| Max. Negotiated Rate |
$513.56 |
| Rate for Payer: Cash Price |
$41.51
|
| Rate for Payer: Cash Price |
$41.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$40.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$40.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$42.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$45.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$42.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$45.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$33.80
|
| Rate for Payer: Healthfirst Medicare Advantage |
$42.82
|
| Rate for Payer: Healthfirst QHP |
$45.07
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$31.55
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$45.07
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$38.31
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$31.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$45.07
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$118.31
|
| Rate for Payer: SOMOS Essential |
$118.31
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$45.07
|
|
|
CHG VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL
|
Professional
|
$527.00
|
|
|
Service Code
|
HCPCS 78457 TC
|
| Min. Negotiated Rate |
$31.55 |
| Max. Negotiated Rate |
$513.56 |
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Cash Price |
$141.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$135.51
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$135.51
|
| Rate for Payer: Fidelis Essential Plan QHP |
$143.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$150.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$143.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$150.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$150.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$112.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$143.04
|
| Rate for Payer: Healthfirst QHP |
$150.57
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$105.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$150.57
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$127.98
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$105.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$150.57
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$395.25
|
| Rate for Payer: SOMOS Essential |
$395.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$150.57
|
|
|
CHG VERTEBRAL FRACTURE ASSESSMENT VIA DXA
|
Professional
|
$32.66
|
|
|
Service Code
|
HCPCS 77086 26
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$106.31 |
| Rate for Payer: Cash Price |
$8.91
|
| Rate for Payer: Cash Price |
$8.91
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.40
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.86
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.33
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.33
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.86
|
| Rate for Payer: Healthfirst QHP |
$9.33
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$6.53
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$9.33
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$7.93
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$6.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.33
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24.50
|
| Rate for Payer: SOMOS Essential |
$24.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.33
|
|
|
CHG VERTEBRAL FRACTURE ASSESSMENT VIA DXA
|
Professional
|
$141.75
|
|
|
Service Code
|
HCPCS 77086
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$106.31 |
| Rate for Payer: Cash Price |
$39.40
|
| Rate for Payer: Cash Price |
$39.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36.45
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$36.45
|
| Rate for Payer: Fidelis Essential Plan QHP |
$38.48
|
| Rate for Payer: Fidelis Medicare Advantage |
$40.50
|
| Rate for Payer: Fidelis Qualified Health Plan |
$38.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$40.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$38.48
|
| Rate for Payer: Healthfirst QHP |
$40.50
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$28.35
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$40.50
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$34.42
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$28.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$40.50
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$106.31
|
| Rate for Payer: SOMOS Essential |
$106.31
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$40.50
|
|
|
CHG VERTEBRAL FRACTURE ASSESSMENT VIA DXA
|
Professional
|
$109.10
|
|
|
Service Code
|
HCPCS 77086 TC
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$106.31 |
| Rate for Payer: Cash Price |
$30.49
|
| Rate for Payer: Cash Price |
$30.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$28.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$28.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$29.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$31.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$29.61
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$31.17
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$31.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$29.61
|
| Rate for Payer: Healthfirst QHP |
$31.17
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$21.82
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$31.17
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$26.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$21.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$31.17
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$81.82
|
| Rate for Payer: SOMOS Essential |
$81.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$31.17
|
|
|
CHG WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU
|
Professional
|
$424.97
|
|
|
Service Code
|
HCPCS 78122
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$318.73 |
| Rate for Payer: Cash Price |
$114.93
|
| Rate for Payer: Cash Price |
$114.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$109.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$109.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$115.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$121.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$115.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$121.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$121.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$91.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$115.35
|
| Rate for Payer: Healthfirst QHP |
$121.42
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$84.99
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$121.42
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$103.21
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$84.99
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$121.42
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$318.73
|
| Rate for Payer: SOMOS Essential |
$318.73
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$121.42
|
|
|
CHG WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU
|
Professional
|
$343.00
|
|
|
Service Code
|
HCPCS 78122 TC
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$318.73 |
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Cash Price |
$92.88
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$88.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$88.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$93.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$98.00
|
| Rate for Payer: Fidelis Qualified Health Plan |
$93.10
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$98.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$98.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$73.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$93.10
|
| Rate for Payer: Healthfirst QHP |
$98.00
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$68.60
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$98.00
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$83.30
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$68.60
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$98.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$257.25
|
| Rate for Payer: SOMOS Essential |
$257.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$98.00
|
|
|
CHG WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU
|
Professional
|
$81.97
|
|
|
Service Code
|
HCPCS 78122 26
|
| Min. Negotiated Rate |
$16.39 |
| Max. Negotiated Rate |
$318.73 |
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Cash Price |
$22.05
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$21.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$22.25
|
| Rate for Payer: Fidelis Medicare Advantage |
$23.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$23.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22.25
|
| Rate for Payer: Healthfirst QHP |
$23.42
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$16.39
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$23.42
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$19.91
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$16.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$23.42
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$61.48
|
| Rate for Payer: SOMOS Essential |
$61.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$23.42
|
|
|
CHICKEN POX VACCINE
|
Facility
OP
|
$25.63
|
|
|
Service Code
|
HCPCS 90716
|
| Hospital Charge Code |
30301178
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.97 |
| Max. Negotiated Rate |
$153.87 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$14.10
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$153.87
|
| Rate for Payer: Aetna Government |
$153.87
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$12.82
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$14.74
|
| Rate for Payer: Group Health Inc Commercial |
$12.82
|
| Rate for Payer: Group Health Inc Medicare |
$8.97
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16.66
|
|
|
CHICKEN POX VACCINE
|
Facility
IP
|
$25.63
|
|
|
Service Code
|
HCPCS 90716
|
| Hospital Charge Code |
30301178
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.82 |
| Max. Negotiated Rate |
$12.82 |
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.82
|
|
|
CHIKUNGUNYA ABS, IGG/IGM
|
Facility
OP
|
$32.20
|
|
|
Service Code
|
HCPCS 86790
|
| Hospital Charge Code |
40729387
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.30 |
| Max. Negotiated Rate |
$20.48 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$17.71
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$12.88
|
| Rate for Payer: Aetna Government |
$12.88
|
| Rate for Payer: Cash Price |
$12.88
|
| Rate for Payer: Cash Price |
$12.88
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12.88
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$20.48
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$17.32
|
| Rate for Payer: Elderplan Medicare Advantage |
$12.88
|
| Rate for Payer: EmblemHealth Commercial |
$12.88
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$11.59
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$10.95
|
| Rate for Payer: Fidelis Essential Plan QHP |
$11.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$12.88
|
| Rate for Payer: Fidelis Qualified Health Plan |
$11.46
|
| Rate for Payer: Group Health Inc Commercial |
$12.88
|
| Rate for Payer: Group Health Inc Medicare |
$12.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.88
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12.88
|
| Rate for Payer: Healthfirst QHP |
$12.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12.88
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$10.30
|
| Rate for Payer: Wellcare Medicare |
$11.59
|
|
|
CHILDHOOD ALLERGY PROFILE
|
Facility
OP
|
$41.15
|
|
|
Service Code
|
HCPCS 82785
|
| Hospital Charge Code |
40728347
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.17 |
| Max. Negotiated Rate |
$26.18 |
| Rate for Payer: 1199SEIU National Benefit Fund Commercial |
$22.63
|
| Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper |
$16.46
|
| Rate for Payer: Aetna Government |
$16.46
|
| Rate for Payer: Cash Price |
$16.46
|
| Rate for Payer: Cash Price |
$16.46
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$16.46
|
| Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access |
$26.18
|
| Rate for Payer: Cigna LocalPlus Benefit Plan |
$22.15
|
| Rate for Payer: Elderplan Medicare Advantage |
$16.46
|
| Rate for Payer: EmblemHealth Commercial |
$16.46
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$14.81
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$13.99
|
| Rate for Payer: Fidelis Essential Plan QHP |
$14.65
|
| Rate for Payer: Fidelis Medicare Advantage |
$16.46
|
| Rate for Payer: Fidelis Qualified Health Plan |
$14.65
|
| Rate for Payer: Group Health Inc Commercial |
$16.46
|
| Rate for Payer: Group Health Inc Medicare |
$16.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$20.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.46
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.46
|
| Rate for Payer: Healthfirst Medicare Advantage |
$16.46
|
| Rate for Payer: Healthfirst QHP |
$16.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$16.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16.46
|
| Rate for Payer: Wellcare CHP/FHP/Medicaid |
$13.17
|
| Rate for Payer: Wellcare Medicare |
$14.81
|
|
