|
PR ANALYSIS, NERVE
|
Professional
|
Both
|
$953.61
|
|
|
Service Code
|
HCPCS 88356
|
| Min. Negotiated Rate |
$184.78 |
| Max. Negotiated Rate |
$593.93 |
| Rate for Payer: Cash Price |
$266.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$263.97
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$237.57
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$237.57
|
| Rate for Payer: Fidelis Essential Plan QHP |
$250.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$263.97
|
| Rate for Payer: Fidelis Qualified Health Plan |
$250.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$263.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$263.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$197.98
|
| Rate for Payer: Healthfirst Commercial |
$263.97
|
| Rate for Payer: Healthfirst Essential Plan |
$593.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$250.77
|
| Rate for Payer: Healthfirst QHP |
$263.97
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$184.78
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$263.97
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$224.37
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$184.78
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$263.97
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$197.98
|
| Rate for Payer: SOMOS Essential |
$197.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$263.97
|
|
|
PR ANALYSIS, NERVE
|
Professional
|
Both
|
$486.75
|
|
|
Service Code
|
HCPCS 88356 TC
|
| Min. Negotiated Rate |
$97.27 |
| Max. Negotiated Rate |
$312.64 |
| Rate for Payer: Cash Price |
$139.32
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$138.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$125.06
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$125.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$132.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$138.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$132.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$138.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$138.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$104.21
|
| Rate for Payer: Healthfirst Commercial |
$138.95
|
| Rate for Payer: Healthfirst Essential Plan |
$312.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$132.00
|
| Rate for Payer: Healthfirst QHP |
$138.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$97.27
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$138.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$118.11
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$97.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$138.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$104.21
|
| Rate for Payer: SOMOS Essential |
$104.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$138.95
|
|
|
PR ANALYSIS, NERVE
|
Professional
|
Both
|
$466.87
|
|
|
Service Code
|
HCPCS 88356 26
|
| Min. Negotiated Rate |
$87.51 |
| Max. Negotiated Rate |
$281.30 |
| Rate for Payer: Cash Price |
$127.58
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$125.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$112.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$112.52
|
| Rate for Payer: Fidelis Essential Plan QHP |
$118.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$125.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$118.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$125.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$125.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$93.77
|
| Rate for Payer: Healthfirst Commercial |
$125.02
|
| Rate for Payer: Healthfirst Essential Plan |
$281.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$118.77
|
| Rate for Payer: Healthfirst QHP |
$125.02
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$87.51
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$125.02
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$106.27
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$87.51
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$125.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$93.77
|
| Rate for Payer: SOMOS Essential |
$93.77
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$125.02
|
|
|
PR ANALYSIS, TUMOR
|
Professional
|
Both
|
$582.89
|
|
|
Service Code
|
HCPCS 88358
|
| Min. Negotiated Rate |
$107.35 |
| Max. Negotiated Rate |
$345.06 |
| Rate for Payer: Cash Price |
$157.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$153.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$138.02
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$138.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$145.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$153.36
|
| Rate for Payer: Fidelis Qualified Health Plan |
$145.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$153.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$153.36
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$115.02
|
| Rate for Payer: Healthfirst Commercial |
$153.36
|
| Rate for Payer: Healthfirst Essential Plan |
$345.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$145.69
|
| Rate for Payer: Healthfirst QHP |
$153.36
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$107.35
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$153.36
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$130.36
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$107.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$153.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$115.02
|
| Rate for Payer: SOMOS Essential |
$115.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$153.36
|
|
|
PR ANALYSIS, TUMOR
|
Professional
|
Both
|
$192.01
|
|
|
Service Code
|
HCPCS 88358 26
|
| Min. Negotiated Rate |
$36.27 |
| Max. Negotiated Rate |
$116.59 |
| Rate for Payer: Cash Price |
$52.46
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$51.82
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$46.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$46.64
|
| Rate for Payer: Fidelis Essential Plan QHP |
$49.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$51.82
|
| Rate for Payer: Fidelis Qualified Health Plan |
$49.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$51.82
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$38.87
|
| Rate for Payer: Healthfirst Commercial |
$51.82
|
| Rate for Payer: Healthfirst Essential Plan |
$116.59
|
| Rate for Payer: Healthfirst Medicare Advantage |
$49.23
|
| Rate for Payer: Healthfirst QHP |
$51.82
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$36.27
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$51.82
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$44.05
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$36.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$51.82
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$38.87
|
| Rate for Payer: SOMOS Essential |
$38.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$51.82
|
|
|
PR ANALYSIS, TUMOR
|
Professional
|
Both
|
$390.85
|
|
|
Service Code
|
HCPCS 88358 TC
|
| Min. Negotiated Rate |
$71.08 |
| Max. Negotiated Rate |
$228.47 |
| Rate for Payer: Cash Price |
$105.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$101.54
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$91.39
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$91.39
|
| Rate for Payer: Fidelis Essential Plan QHP |
$96.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$101.54
|
| Rate for Payer: Fidelis Qualified Health Plan |
$96.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$101.54
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$101.54
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$76.16
|
| Rate for Payer: Healthfirst Commercial |
$101.54
|
| Rate for Payer: Healthfirst Essential Plan |
$228.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$96.46
|
| Rate for Payer: Healthfirst QHP |
$101.54
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$71.08
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$101.54
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$86.31
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$71.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$101.54
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$76.16
|
| Rate for Payer: SOMOS Essential |
$76.16
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$101.54
|
|
|
PR ANALYSIS W/PRGRMG AUD BRAINSTEM IMPLANT PR HR
|
Professional
|
Both
|
$370.83
|
|
|
Service Code
|
HCPCS 92640
|
| Min. Negotiated Rate |
$38.36 |
| Max. Negotiated Rate |
$228.44 |
| Rate for Payer: Amida Care Medicaid |
$38.36
|
| Rate for Payer: Cash Price |
$101.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$101.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$91.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$91.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$96.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$101.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$96.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$101.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$101.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$76.15
|
| Rate for Payer: Healthfirst Commercial |
$101.53
|
| Rate for Payer: Healthfirst Essential Plan |
$228.44
|
| Rate for Payer: Healthfirst Medicare Advantage |
$96.45
|
| Rate for Payer: Healthfirst QHP |
$101.53
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$71.07
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$101.53
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$86.30
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$71.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$101.53
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$76.15
|
| Rate for Payer: SOMOS Essential |
$76.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$101.53
|
|
|
PR ANAST ARTL EXTRACRANIAL-INTRACRANIAL ARTERIES
|
Professional
|
Both
|
$12,316.15
|
|
|
Service Code
|
HCPCS 61711
|
| Min. Negotiated Rate |
$2,296.43 |
| Max. Negotiated Rate |
$7,381.40 |
| Rate for Payer: Cash Price |
$3,312.25
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,280.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,952.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,952.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,116.59
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,280.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,116.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,280.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,280.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,460.47
|
| Rate for Payer: Healthfirst Commercial |
$3,280.62
|
| Rate for Payer: Healthfirst Essential Plan |
$7,381.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,116.59
|
| Rate for Payer: Healthfirst QHP |
$3,280.62
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,296.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,280.62
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,788.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,296.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,280.62
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,460.47
|
| Rate for Payer: SOMOS Essential |
$2,460.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,280.62
|
|
|
PR ANAST INTRAHEPATC DUCTS & GI TRACT
|
Professional
|
Both
|
$13,155.84
|
|
|
Service Code
|
HCPCS 47765
|
| Min. Negotiated Rate |
$2,523.73 |
| Max. Negotiated Rate |
$8,111.99 |
| Rate for Payer: Cash Price |
$3,640.48
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,605.33
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,244.80
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,244.80
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,425.06
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,605.33
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,425.06
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,605.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,605.33
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,704.00
|
| Rate for Payer: Healthfirst Commercial |
$3,605.33
|
| Rate for Payer: Healthfirst Essential Plan |
$8,111.99
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,425.06
|
| Rate for Payer: Healthfirst QHP |
$3,605.33
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,523.73
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,605.33
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$3,064.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,523.73
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,605.33
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,704.00
|
| Rate for Payer: SOMOS Essential |
$2,704.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,605.33
|
|
|
PR ANASTOMOSIS CAVOPULMARY 2ND SUPRIOR VENA CAVA
|
Professional
|
Both
|
$1,850.63
|
|
|
Service Code
|
HCPCS 33768
|
| Min. Negotiated Rate |
$338.32 |
| Max. Negotiated Rate |
$1,087.45 |
| Rate for Payer: Cash Price |
$489.32
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$483.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$434.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$434.98
|
| Rate for Payer: Fidelis Essential Plan QHP |
$459.14
|
| Rate for Payer: Fidelis Medicare Advantage |
$483.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$459.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$483.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$483.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$362.48
|
| Rate for Payer: Healthfirst Commercial |
$483.31
|
| Rate for Payer: Healthfirst Essential Plan |
$1,087.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$459.14
|
| Rate for Payer: Healthfirst QHP |
$483.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$338.32
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$483.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$410.81
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$338.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$483.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$362.48
|
| Rate for Payer: SOMOS Essential |
$362.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$483.31
|
|
|
PR ANASTOMOSIS FACIAL HYPOGLOSSAL
|
Professional
|
Both
|
$4,290.86
|
|
|
Service Code
|
HCPCS 64868
|
| Min. Negotiated Rate |
$799.15 |
| Max. Negotiated Rate |
$2,568.69 |
| Rate for Payer: Cash Price |
$1,159.52
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,141.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,027.48
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,027.48
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,084.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,141.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,084.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,141.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,141.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$856.23
|
| Rate for Payer: Healthfirst Commercial |
$1,141.64
|
| Rate for Payer: Healthfirst Essential Plan |
$2,568.69
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,084.56
|
| Rate for Payer: Healthfirst QHP |
$1,141.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$799.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,141.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$970.39
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$799.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,141.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$856.23
|
| Rate for Payer: SOMOS Essential |
$856.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,141.64
|
|
|
PR ANASTOMOSIS FACIAL-SPINAL ACCESSORY
|
Professional
|
Both
|
$5,441.10
|
|
|
Service Code
|
HCPCS 64866
|
| Min. Negotiated Rate |
$1,015.15 |
| Max. Negotiated Rate |
$3,262.99 |
| Rate for Payer: Cash Price |
$1,462.69
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,450.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,305.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,305.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,377.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,450.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,377.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,450.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,450.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,087.66
|
| Rate for Payer: Healthfirst Commercial |
$1,450.22
|
| Rate for Payer: Healthfirst Essential Plan |
$3,262.99
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,377.71
|
| Rate for Payer: Healthfirst QHP |
$1,450.22
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,015.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,450.22
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,232.69
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,015.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,450.22
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,087.66
|
| Rate for Payer: SOMOS Essential |
$1,087.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,450.22
|
|
|
PR ANAST PULMONARY ART AORTA DAMUS-KAYE-STANSEL PX
|
Professional
|
Both
|
$7,916.13
|
|
|
Service Code
|
HCPCS 33606
|
| Min. Negotiated Rate |
$1,459.23 |
| Max. Negotiated Rate |
$4,690.37 |
| Rate for Payer: Cash Price |
$2,105.65
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,084.61
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,876.15
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,876.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,980.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,084.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,980.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,084.61
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,084.61
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,563.46
|
| Rate for Payer: Healthfirst Commercial |
$2,084.61
|
| Rate for Payer: Healthfirst Essential Plan |
$4,690.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,980.38
|
| Rate for Payer: Healthfirst QHP |
$2,084.61
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,459.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,084.61
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,771.92
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,459.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,084.61
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,563.46
|
| Rate for Payer: SOMOS Essential |
$1,563.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,084.61
|
|
|
PR ANAST ROUX-EN-Y INTRAHEPATC BILIARY DUCTS & GI
|
Professional
|
Both
|
$14,588.42
|
|
|
Service Code
|
HCPCS 47785
|
| Min. Negotiated Rate |
$2,680.94 |
| Max. Negotiated Rate |
$8,617.32 |
| Rate for Payer: Cash Price |
$3,880.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,829.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,446.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,446.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,638.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,829.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,638.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,829.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,829.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,872.44
|
| Rate for Payer: Healthfirst Commercial |
$3,829.92
|
| Rate for Payer: Healthfirst Essential Plan |
$8,617.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,638.42
|
| Rate for Payer: Healthfirst QHP |
$3,829.92
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,680.94
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,829.92
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$3,255.43
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,680.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,829.92
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,872.44
|
| Rate for Payer: SOMOS Essential |
$2,872.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,829.92
|
|
|
PR ANAST ROUX-EN-Y XTRHEPATC BILIARY DUCTS & GI
|
Professional
|
Both
|
$11,158.98
|
|
|
Service Code
|
HCPCS 47780
|
| Min. Negotiated Rate |
$2,058.64 |
| Max. Negotiated Rate |
$6,617.07 |
| Rate for Payer: Cash Price |
$2,973.63
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,940.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,646.83
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,646.83
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,793.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,940.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,793.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,940.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,940.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,205.69
|
| Rate for Payer: Healthfirst Commercial |
$2,940.92
|
| Rate for Payer: Healthfirst Essential Plan |
$6,617.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,793.87
|
| Rate for Payer: Healthfirst QHP |
$2,940.92
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,058.64
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,940.92
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,499.78
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,058.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,940.92
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,205.69
|
| Rate for Payer: SOMOS Essential |
$2,205.69
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,940.92
|
|
|
PR ANAST XTRHEPATC BILIARY DUCTS & GI TRACT
|
Professional
|
Both
|
$10,136.46
|
|
|
Service Code
|
HCPCS 47760
|
| Min. Negotiated Rate |
$1,869.71 |
| Max. Negotiated Rate |
$6,009.80 |
| Rate for Payer: Cash Price |
$2,700.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,671.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,403.92
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,403.92
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,537.47
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,671.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,537.47
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,671.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,671.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,003.27
|
| Rate for Payer: Healthfirst Commercial |
$2,671.02
|
| Rate for Payer: Healthfirst Essential Plan |
$6,009.80
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,537.47
|
| Rate for Payer: Healthfirst QHP |
$2,671.02
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,869.71
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,671.02
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,270.37
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,869.71
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,671.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,003.27
|
| Rate for Payer: SOMOS Essential |
$2,003.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,671.02
|
|
|
PR ANGIOSCOPY NON-CORONARY VESSEL/GRAFTS THER IVNTJ
|
Professional
|
Both
|
$654.68
|
|
|
Service Code
|
HCPCS 35400
|
| Min. Negotiated Rate |
$116.97 |
| Max. Negotiated Rate |
$375.98 |
| Rate for Payer: Cash Price |
$173.32
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$167.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$150.39
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$150.39
|
| Rate for Payer: Fidelis Essential Plan QHP |
$158.75
|
| Rate for Payer: Fidelis Medicare Advantage |
$167.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$158.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$167.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$167.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$125.33
|
| Rate for Payer: Healthfirst Commercial |
$167.10
|
| Rate for Payer: Healthfirst Essential Plan |
$375.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$158.75
|
| Rate for Payer: Healthfirst QHP |
$167.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$116.97
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$167.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$142.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$116.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$167.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$125.33
|
| Rate for Payer: SOMOS Essential |
$125.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$167.10
|
|
|
PR ANKLE DISARTICULATION
|
Professional
|
Both
|
$2,814.91
|
|
|
Service Code
|
HCPCS 27889
|
| Min. Negotiated Rate |
$527.15 |
| Max. Negotiated Rate |
$1,694.41 |
| Rate for Payer: Cash Price |
$759.65
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$753.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$677.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$677.76
|
| Rate for Payer: Fidelis Essential Plan QHP |
$715.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$753.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$715.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$753.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$753.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$564.80
|
| Rate for Payer: Healthfirst Commercial |
$753.07
|
| Rate for Payer: Healthfirst Essential Plan |
$1,694.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$715.42
|
| Rate for Payer: Healthfirst QHP |
$753.07
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$527.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$753.07
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$640.11
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$527.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$753.07
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$564.80
|
| Rate for Payer: SOMOS Essential |
$564.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$753.07
|
|
|
PR ANNUAL ALCOHOL SCREEN 15 MIN
|
Professional
|
Both
|
$36.79
|
|
|
Service Code
|
HCPCS G0442
|
| Min. Negotiated Rate |
$6.94 |
| Max. Negotiated Rate |
$22.32 |
| Rate for Payer: Cash Price |
$10.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$9.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$9.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.44
|
| Rate for Payer: Healthfirst Commercial |
$9.92
|
| Rate for Payer: Healthfirst Essential Plan |
$22.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.42
|
| Rate for Payer: Healthfirst QHP |
$9.92
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$6.94
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$9.92
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$8.43
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$6.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.92
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$7.44
|
| Rate for Payer: SOMOS Essential |
$7.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.92
|
|
|
PR ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG
|
Professional
|
Both
|
$344.02
|
|
|
Service Code
|
HCPCS 99170
|
| Min. Negotiated Rate |
$43.56 |
| Max. Negotiated Rate |
$208.75 |
| Rate for Payer: Amida Care Medicaid |
$43.56
|
| Rate for Payer: Cash Price |
$93.68
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$92.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$83.50
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$83.50
|
| Rate for Payer: Fidelis Essential Plan QHP |
$88.14
|
| Rate for Payer: Fidelis Medicare Advantage |
$92.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$88.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$92.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$92.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$69.58
|
| Rate for Payer: Healthfirst Commercial |
$92.78
|
| Rate for Payer: Healthfirst Essential Plan |
$208.75
|
| Rate for Payer: Healthfirst Medicare Advantage |
$88.14
|
| Rate for Payer: Healthfirst QHP |
$92.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$64.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$92.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$78.86
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$64.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$92.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$69.58
|
| Rate for Payer: SOMOS Essential |
$69.58
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$92.78
|
|
|
PR ANOPLASTY PLASTIC OPERATION STRICTURE ADULT
|
Professional
|
Both
|
$2,841.48
|
|
|
Service Code
|
HCPCS 46700
|
| Min. Negotiated Rate |
$535.02 |
| Max. Negotiated Rate |
$1,719.70 |
| Rate for Payer: Cash Price |
$765.22
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$764.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$687.88
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$687.88
|
| Rate for Payer: Fidelis Essential Plan QHP |
$726.09
|
| Rate for Payer: Fidelis Medicare Advantage |
$764.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$726.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$764.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$764.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$573.23
|
| Rate for Payer: Healthfirst Commercial |
$764.31
|
| Rate for Payer: Healthfirst Essential Plan |
$1,719.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$726.09
|
| Rate for Payer: Healthfirst QHP |
$764.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$535.02
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$764.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$649.66
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$535.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$764.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$573.23
|
| Rate for Payer: SOMOS Essential |
$573.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$764.31
|
|
|
PR ANOPLASTY PLASTIC OPERATION STRICTURE INFANT
|
Professional
|
Both
|
$2,582.06
|
|
|
Service Code
|
HCPCS 46705
|
| Min. Negotiated Rate |
$483.10 |
| Max. Negotiated Rate |
$1,552.82 |
| Rate for Payer: Cash Price |
$690.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$690.14
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$621.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$621.13
|
| Rate for Payer: Fidelis Essential Plan QHP |
$655.63
|
| Rate for Payer: Fidelis Medicare Advantage |
$690.14
|
| Rate for Payer: Fidelis Qualified Health Plan |
$655.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$690.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$690.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$517.61
|
| Rate for Payer: Healthfirst Commercial |
$690.14
|
| Rate for Payer: Healthfirst Essential Plan |
$1,552.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$655.63
|
| Rate for Payer: Healthfirst QHP |
$690.14
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$483.10
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$690.14
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$586.62
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$483.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$690.14
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$517.61
|
| Rate for Payer: SOMOS Essential |
$517.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$690.14
|
|
|
PR ANORECTAL MANOMETRY
|
Professional
|
Both
|
$351.12
|
|
|
Service Code
|
HCPCS 91122 26
|
| Min. Negotiated Rate |
$65.98 |
| Max. Negotiated Rate |
$212.09 |
| Rate for Payer: Amida Care Medicaid |
$197.64
|
| Rate for Payer: Cash Price |
$95.65
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$94.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$84.83
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$84.83
|
| Rate for Payer: Fidelis Essential Plan QHP |
$89.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$94.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$89.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$94.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$94.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$70.69
|
| Rate for Payer: Healthfirst Commercial |
$94.26
|
| Rate for Payer: Healthfirst Essential Plan |
$212.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$89.55
|
| Rate for Payer: Healthfirst QHP |
$94.26
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$65.98
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$94.26
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$80.12
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$65.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$94.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$70.69
|
| Rate for Payer: SOMOS Essential |
$70.69
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$94.26
|
|
|
PR ANORECTAL MANOMETRY
|
Professional
|
Both
|
$813.33
|
|
|
Service Code
|
HCPCS 91122 TC
|
| Min. Negotiated Rate |
$152.37 |
| Max. Negotiated Rate |
$489.76 |
| Rate for Payer: Amida Care Medicaid |
$197.64
|
| Rate for Payer: Cash Price |
$224.67
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$217.67
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$195.90
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$195.90
|
| Rate for Payer: Fidelis Essential Plan QHP |
$206.79
|
| Rate for Payer: Fidelis Medicare Advantage |
$217.67
|
| Rate for Payer: Fidelis Qualified Health Plan |
$206.79
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$217.67
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$217.67
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$163.25
|
| Rate for Payer: Healthfirst Commercial |
$217.67
|
| Rate for Payer: Healthfirst Essential Plan |
$489.76
|
| Rate for Payer: Healthfirst Medicare Advantage |
$206.79
|
| Rate for Payer: Healthfirst QHP |
$217.67
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$152.37
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$217.67
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$185.02
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$152.37
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$217.67
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$163.25
|
| Rate for Payer: SOMOS Essential |
$163.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$217.67
|
|
|
PR ANORECTAL MANOMETRY
|
Professional
|
Both
|
$1,164.45
|
|
|
Service Code
|
HCPCS 91122
|
| Min. Negotiated Rate |
$197.64 |
| Max. Negotiated Rate |
$701.84 |
| Rate for Payer: Amida Care Medicaid |
$197.64
|
| Rate for Payer: Cash Price |
$320.32
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$311.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$280.74
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$280.74
|
| Rate for Payer: Fidelis Essential Plan QHP |
$296.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$311.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$296.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$311.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$311.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$233.95
|
| Rate for Payer: Healthfirst Commercial |
$311.93
|
| Rate for Payer: Healthfirst Essential Plan |
$701.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$296.33
|
| Rate for Payer: Healthfirst QHP |
$311.93
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$218.35
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$311.93
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$265.14
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$218.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$311.93
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$233.95
|
| Rate for Payer: SOMOS Essential |
$233.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$311.93
|
|
