|
PR ANORECTAL MYOMECTOMY
|
Professional
|
Both
|
$1,687.25
|
|
|
Service Code
|
HCPCS 45108
|
| Min. Negotiated Rate |
$316.39 |
| Max. Negotiated Rate |
$1,016.96 |
| Rate for Payer: Cash Price |
$454.23
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$451.98
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$406.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$406.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$429.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$451.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$429.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$451.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$451.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$338.99
|
| Rate for Payer: Healthfirst Commercial |
$451.98
|
| Rate for Payer: Healthfirst Essential Plan |
$1,016.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$429.38
|
| Rate for Payer: Healthfirst QHP |
$451.98
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$316.39
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$451.98
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$384.18
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$316.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$451.98
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$338.99
|
| Rate for Payer: SOMOS Essential |
$338.99
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$451.98
|
|
|
PR ANOSCOPY ABLATION LESION
|
Professional
|
Both
|
$380.73
|
|
|
Service Code
|
HCPCS 46615
|
| Min. Negotiated Rate |
$72.70 |
| Max. Negotiated Rate |
$233.69 |
| Rate for Payer: Cash Price |
$104.74
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$103.86
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$93.47
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$93.47
|
| Rate for Payer: Fidelis Essential Plan QHP |
$98.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$103.86
|
| Rate for Payer: Fidelis Qualified Health Plan |
$98.67
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$103.86
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$103.86
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$77.89
|
| Rate for Payer: Healthfirst Commercial |
$103.86
|
| Rate for Payer: Healthfirst Essential Plan |
$233.69
|
| Rate for Payer: Healthfirst Medicare Advantage |
$98.67
|
| Rate for Payer: Healthfirst QHP |
$103.86
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$72.70
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$103.86
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$88.28
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$72.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$103.86
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$77.89
|
| Rate for Payer: SOMOS Essential |
$77.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$103.86
|
|
|
PR ANOSCOPY CONTROL BLEEDING
|
Professional
|
Both
|
$279.58
|
|
|
Service Code
|
HCPCS 46614
|
| Min. Negotiated Rate |
$52.50 |
| Max. Negotiated Rate |
$168.75 |
| Rate for Payer: Cash Price |
$75.14
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$75.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$67.50
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$67.50
|
| Rate for Payer: Fidelis Essential Plan QHP |
$71.25
|
| Rate for Payer: Fidelis Medicare Advantage |
$75.00
|
| Rate for Payer: Fidelis Qualified Health Plan |
$71.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$75.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$75.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$56.25
|
| Rate for Payer: Healthfirst Commercial |
$75.00
|
| Rate for Payer: Healthfirst Essential Plan |
$168.75
|
| Rate for Payer: Healthfirst Medicare Advantage |
$71.25
|
| Rate for Payer: Healthfirst QHP |
$75.00
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$52.50
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$75.00
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$63.75
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$52.50
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$75.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$56.25
|
| Rate for Payer: SOMOS Essential |
$56.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$75.00
|
|
|
PR ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD
|
Professional
|
Both
|
$179.62
|
|
|
Service Code
|
HCPCS 46600
|
| Min. Negotiated Rate |
$33.57 |
| Max. Negotiated Rate |
$107.91 |
| Rate for Payer: Cash Price |
$48.39
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$47.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$43.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$43.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$45.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$47.96
|
| Rate for Payer: Fidelis Qualified Health Plan |
$45.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$47.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$47.96
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$35.97
|
| Rate for Payer: Healthfirst Commercial |
$47.96
|
| Rate for Payer: Healthfirst Essential Plan |
$107.91
|
| Rate for Payer: Healthfirst Medicare Advantage |
$45.56
|
| Rate for Payer: Healthfirst QHP |
$47.96
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$33.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$47.96
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$40.77
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$33.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$47.96
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$35.97
|
| Rate for Payer: SOMOS Essential |
$35.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$47.96
|
|
|
PR ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT
|
Professional
|
Both
|
$395.71
|
|
|
Service Code
|
HCPCS 46601
|
| Min. Negotiated Rate |
$74.84 |
| Max. Negotiated Rate |
$240.57 |
| Rate for Payer: Cash Price |
$108.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$106.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$96.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$96.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$101.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$106.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$101.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$106.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$106.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$80.19
|
| Rate for Payer: Healthfirst Commercial |
$106.92
|
| Rate for Payer: Healthfirst Essential Plan |
$240.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$101.57
|
| Rate for Payer: Healthfirst QHP |
$106.92
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$74.84
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$106.92
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$90.88
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$74.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$106.92
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$80.19
|
| Rate for Payer: SOMOS Essential |
$80.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$106.92
|
|
|
PR ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX
|
Professional
|
Both
|
$527.24
|
|
|
Service Code
|
HCPCS 46607
|
| Min. Negotiated Rate |
$98.75 |
| Max. Negotiated Rate |
$317.41 |
| Rate for Payer: Cash Price |
$143.90
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$141.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$126.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$126.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$134.02
|
| Rate for Payer: Fidelis Medicare Advantage |
$141.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$134.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$141.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$141.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$105.80
|
| Rate for Payer: Healthfirst Commercial |
$141.07
|
| Rate for Payer: Healthfirst Essential Plan |
$317.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$134.02
|
| Rate for Payer: Healthfirst QHP |
$141.07
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$98.75
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$141.07
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$119.91
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$98.75
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$141.07
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$105.80
|
| Rate for Payer: SOMOS Essential |
$105.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$141.07
|
|
|
PR ANOSCOPY W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$324.35
|
|
|
Service Code
|
HCPCS 46606
|
| Min. Negotiated Rate |
$61.66 |
| Max. Negotiated Rate |
$198.20 |
| Rate for Payer: Cash Price |
$88.39
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$88.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$79.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$79.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$83.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$88.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$83.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$88.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$88.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$66.07
|
| Rate for Payer: Healthfirst Commercial |
$88.09
|
| Rate for Payer: Healthfirst Essential Plan |
$198.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$83.69
|
| Rate for Payer: Healthfirst QHP |
$88.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$61.66
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$88.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$74.88
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$61.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$88.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$66.07
|
| Rate for Payer: SOMOS Essential |
$66.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$88.09
|
|
|
PR ANOSCOPY W/DILATION
|
Professional
|
Both
|
$286.06
|
|
|
Service Code
|
HCPCS 46604
|
| Min. Negotiated Rate |
$53.23 |
| Max. Negotiated Rate |
$171.09 |
| Rate for Payer: Cash Price |
$77.44
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$76.04
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$68.44
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$68.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$72.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$76.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$72.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$76.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$76.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$57.03
|
| Rate for Payer: Healthfirst Commercial |
$76.04
|
| Rate for Payer: Healthfirst Essential Plan |
$171.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$72.24
|
| Rate for Payer: Healthfirst QHP |
$76.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$53.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$76.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$64.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$53.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$76.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$57.03
|
| Rate for Payer: SOMOS Essential |
$57.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$76.04
|
|
|
PR ANOSCOPY W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$382.34
|
|
|
Service Code
|
HCPCS 46608
|
| Min. Negotiated Rate |
$71.06 |
| Max. Negotiated Rate |
$228.40 |
| Rate for Payer: Cash Price |
$101.97
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$101.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$91.36
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$91.36
|
| Rate for Payer: Fidelis Essential Plan QHP |
$96.43
|
| Rate for Payer: Fidelis Medicare Advantage |
$101.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$96.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$101.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$101.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$76.13
|
| Rate for Payer: Healthfirst Commercial |
$101.51
|
| Rate for Payer: Healthfirst Essential Plan |
$228.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$96.43
|
| Rate for Payer: Healthfirst QHP |
$101.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$71.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$101.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$86.28
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$71.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$101.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$76.13
|
| Rate for Payer: SOMOS Essential |
$76.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$101.51
|
|
|
PR ANOSCOPY W/RMVL LESION CAUTERY
|
Professional
|
Both
|
$352.35
|
|
|
Service Code
|
HCPCS 46610
|
| Min. Negotiated Rate |
$65.54 |
| Max. Negotiated Rate |
$210.67 |
| Rate for Payer: Cash Price |
$94.23
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$93.63
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$84.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$84.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$88.95
|
| Rate for Payer: Fidelis Medicare Advantage |
$93.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$88.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$93.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$93.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$70.22
|
| Rate for Payer: Healthfirst Commercial |
$93.63
|
| Rate for Payer: Healthfirst Essential Plan |
$210.67
|
| Rate for Payer: Healthfirst Medicare Advantage |
$88.95
|
| Rate for Payer: Healthfirst QHP |
$93.63
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$65.54
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$93.63
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$79.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$65.54
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$93.63
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$70.22
|
| Rate for Payer: SOMOS Essential |
$70.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$93.63
|
|
|
PR ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ
|
Professional
|
Both
|
$342.76
|
|
|
Service Code
|
HCPCS 46611
|
| Min. Negotiated Rate |
$65.16 |
| Max. Negotiated Rate |
$209.45 |
| Rate for Payer: Cash Price |
$93.61
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$93.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$83.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$83.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$88.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$93.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$88.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$93.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$93.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$69.82
|
| Rate for Payer: Healthfirst Commercial |
$93.09
|
| Rate for Payer: Healthfirst Essential Plan |
$209.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$88.44
|
| Rate for Payer: Healthfirst QHP |
$93.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$65.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$93.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$79.13
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$65.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$93.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$69.82
|
| Rate for Payer: SOMOS Essential |
$69.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$93.09
|
|
|
PR ANOSC RMVL MULT TUMORS CAUTERY/SNARE
|
Professional
|
Both
|
$425.67
|
|
|
Service Code
|
HCPCS 46612
|
| Min. Negotiated Rate |
$80.22 |
| Max. Negotiated Rate |
$257.85 |
| Rate for Payer: Cash Price |
$114.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$114.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$103.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$103.14
|
| Rate for Payer: Fidelis Essential Plan QHP |
$108.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$114.60
|
| Rate for Payer: Fidelis Qualified Health Plan |
$108.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$114.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$114.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$85.95
|
| Rate for Payer: Healthfirst Commercial |
$114.60
|
| Rate for Payer: Healthfirst Essential Plan |
$257.85
|
| Rate for Payer: Healthfirst Medicare Advantage |
$108.87
|
| Rate for Payer: Healthfirst QHP |
$114.60
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$80.22
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$114.60
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$97.41
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$80.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$114.60
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$85.95
|
| Rate for Payer: SOMOS Essential |
$85.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$114.60
|
|
|
PR ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX
|
Professional
|
Both
|
$452.73
|
|
|
Service Code
|
HCPCS 45990
|
| Min. Negotiated Rate |
$86.76 |
| Max. Negotiated Rate |
$278.87 |
| Rate for Payer: Cash Price |
$123.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$123.94
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$111.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$111.55
|
| Rate for Payer: Fidelis Essential Plan QHP |
$117.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$123.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$117.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$123.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$123.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$92.95
|
| Rate for Payer: Healthfirst Commercial |
$123.94
|
| Rate for Payer: Healthfirst Essential Plan |
$278.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$117.74
|
| Rate for Payer: Healthfirst QHP |
$123.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$86.76
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$123.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$105.35
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$86.76
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$123.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$92.95
|
| Rate for Payer: SOMOS Essential |
$92.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$123.94
|
|
|
PR ANTEPARTUM CARE ONLY 4-6 VISITS
|
Professional
|
Both
|
$1,994.27
|
|
|
Service Code
|
HCPCS 59425
|
| Min. Negotiated Rate |
$364.06 |
| Max. Negotiated Rate |
$1,170.18 |
| Rate for Payer: Cash Price |
$527.17
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$520.08
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$468.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$468.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$494.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$520.08
|
| Rate for Payer: Fidelis Qualified Health Plan |
$494.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$520.08
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$520.08
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$390.06
|
| Rate for Payer: Healthfirst Commercial |
$520.08
|
| Rate for Payer: Healthfirst Essential Plan |
$1,170.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$494.08
|
| Rate for Payer: Healthfirst QHP |
$520.08
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$364.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$520.08
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$442.07
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$364.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$520.08
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$390.06
|
| Rate for Payer: SOMOS Essential |
$390.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$520.08
|
|
|
PR ANTEPARTUM CARE ONLY 7/> VISITS
|
Professional
|
Both
|
$3,665.03
|
|
|
Service Code
|
HCPCS 59426
|
| Min. Negotiated Rate |
$669.86 |
| Max. Negotiated Rate |
$2,153.11 |
| Rate for Payer: Cash Price |
$968.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$956.94
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$861.25
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$861.25
|
| Rate for Payer: Fidelis Essential Plan QHP |
$909.09
|
| Rate for Payer: Fidelis Medicare Advantage |
$956.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$909.09
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$956.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$956.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$717.71
|
| Rate for Payer: Healthfirst Commercial |
$956.94
|
| Rate for Payer: Healthfirst Essential Plan |
$2,153.11
|
| Rate for Payer: Healthfirst Medicare Advantage |
$909.09
|
| Rate for Payer: Healthfirst QHP |
$956.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$669.86
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$956.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$813.40
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$669.86
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$956.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$717.71
|
| Rate for Payer: SOMOS Essential |
$717.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$956.94
|
|
|
PR ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO
|
Professional
|
Both
|
$2,659.93
|
|
|
Service Code
|
HCPCS 57240
|
| Min. Negotiated Rate |
$496.96 |
| Max. Negotiated Rate |
$1,597.39 |
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$709.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$638.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$638.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$674.45
|
| Rate for Payer: Fidelis Medicare Advantage |
$709.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$674.45
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$709.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$709.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$532.46
|
| Rate for Payer: Healthfirst Commercial |
$709.95
|
| Rate for Payer: Healthfirst Essential Plan |
$1,597.39
|
| Rate for Payer: Healthfirst Medicare Advantage |
$674.45
|
| Rate for Payer: Healthfirst QHP |
$709.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$496.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$709.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$603.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$496.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$709.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$532.46
|
| Rate for Payer: SOMOS Essential |
$532.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$709.95
|
|
|
PR ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$3,380.76
|
|
|
Service Code
|
HCPCS 22845
|
| Min. Negotiated Rate |
$617.49 |
| Max. Negotiated Rate |
$1,984.79 |
| Rate for Payer: Cash Price |
$891.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$882.13
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$793.92
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$793.92
|
| Rate for Payer: Fidelis Essential Plan QHP |
$838.02
|
| Rate for Payer: Fidelis Medicare Advantage |
$882.13
|
| Rate for Payer: Fidelis Qualified Health Plan |
$838.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$882.13
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$882.13
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$661.60
|
| Rate for Payer: Healthfirst Commercial |
$882.13
|
| Rate for Payer: Healthfirst Essential Plan |
$1,984.79
|
| Rate for Payer: Healthfirst Medicare Advantage |
$838.02
|
| Rate for Payer: Healthfirst QHP |
$882.13
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$617.49
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$882.13
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$749.81
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$617.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$882.13
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$661.60
|
| Rate for Payer: SOMOS Essential |
$661.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$882.13
|
|
|
PR ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$3,522.12
|
|
|
Service Code
|
HCPCS 22846
|
| Min. Negotiated Rate |
$644.03 |
| Max. Negotiated Rate |
$2,070.09 |
| Rate for Payer: Cash Price |
$928.36
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$920.04
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$828.04
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$828.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$874.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$920.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$874.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$920.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$920.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$690.03
|
| Rate for Payer: Healthfirst Commercial |
$920.04
|
| Rate for Payer: Healthfirst Essential Plan |
$2,070.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$874.04
|
| Rate for Payer: Healthfirst QHP |
$920.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$644.03
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$920.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$782.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$644.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$920.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$690.03
|
| Rate for Payer: SOMOS Essential |
$690.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$920.04
|
|
|
PR ANTERIOR INSTRUMENTATION 8/> VERTEBRAL SEGMENTS
|
Professional
|
Both
|
$3,511.66
|
|
|
Service Code
|
HCPCS 22847
|
| Min. Negotiated Rate |
$651.52 |
| Max. Negotiated Rate |
$2,094.19 |
| Rate for Payer: Cash Price |
$937.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$930.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$837.67
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$837.67
|
| Rate for Payer: Fidelis Essential Plan QHP |
$884.21
|
| Rate for Payer: Fidelis Medicare Advantage |
$930.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$884.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$930.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$930.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$698.06
|
| Rate for Payer: Healthfirst Commercial |
$930.75
|
| Rate for Payer: Healthfirst Essential Plan |
$2,094.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$884.21
|
| Rate for Payer: Healthfirst QHP |
$930.75
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$651.52
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$930.75
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$791.14
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$651.52
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$930.75
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$698.06
|
| Rate for Payer: SOMOS Essential |
$698.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$930.75
|
|
|
PR ANTERIOR TIBIAL TUBERCLEPLASTY
|
Professional
|
Both
|
$3,667.02
|
|
|
Service Code
|
HCPCS 27418
|
| Min. Negotiated Rate |
$677.57 |
| Max. Negotiated Rate |
$2,177.89 |
| Rate for Payer: Cash Price |
$979.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$967.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$871.15
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$871.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$919.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$967.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$919.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$967.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$967.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$725.96
|
| Rate for Payer: Healthfirst Commercial |
$967.95
|
| Rate for Payer: Healthfirst Essential Plan |
$2,177.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$919.55
|
| Rate for Payer: Healthfirst QHP |
$967.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$677.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$967.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$822.76
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$677.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$967.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$725.96
|
| Rate for Payer: SOMOS Essential |
$725.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$967.95
|
|
|
PR ANTICOAGULANT MGMT FOR PT TAKING WARFARIN
|
Professional
|
Both
|
$46.83
|
|
|
Service Code
|
HCPCS 93793
|
| Min. Negotiated Rate |
$8.85 |
| Max. Negotiated Rate |
$28.44 |
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$12.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$11.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$11.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$12.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$12.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$12.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$12.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$12.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$9.48
|
| Rate for Payer: Healthfirst Commercial |
$12.64
|
| Rate for Payer: Healthfirst Essential Plan |
$28.44
|
| Rate for Payer: Healthfirst Medicare Advantage |
$12.01
|
| Rate for Payer: Healthfirst QHP |
$12.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$8.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$12.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$10.74
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$8.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$12.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$9.48
|
| Rate for Payer: SOMOS Essential |
$9.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$12.64
|
|
|
PR ANT SGM IMAGING I&R SPECLR MICROSCOPY&NDTHL ALYS
|
Professional
|
Both
|
$77.49
|
|
|
Service Code
|
HCPCS 92286 TC
|
| Min. Negotiated Rate |
$14.56 |
| Max. Negotiated Rate |
$97.65 |
| Rate for Payer: Amida Care Medicaid |
$97.65
|
| Rate for Payer: Cash Price |
$21.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$20.80
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18.72
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$18.72
|
| Rate for Payer: Fidelis Essential Plan QHP |
$19.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$20.80
|
| Rate for Payer: Fidelis Qualified Health Plan |
$19.76
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$20.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$20.80
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$15.60
|
| Rate for Payer: Healthfirst Commercial |
$20.80
|
| Rate for Payer: Healthfirst Essential Plan |
$46.80
|
| Rate for Payer: Healthfirst Medicare Advantage |
$19.76
|
| Rate for Payer: Healthfirst QHP |
$20.80
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$14.56
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$20.80
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$17.68
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$14.56
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$20.80
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$15.60
|
| Rate for Payer: SOMOS Essential |
$15.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$20.80
|
|
|
PR ANT SGM IMAGING I&R SPECLR MICROSCOPY&NDTHL ALYS
|
Professional
|
Both
|
$161.95
|
|
|
Service Code
|
HCPCS 92286
|
| Min. Negotiated Rate |
$30.62 |
| Max. Negotiated Rate |
$98.42 |
| Rate for Payer: Amida Care Medicaid |
$97.65
|
| Rate for Payer: Cash Price |
$44.67
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$43.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$39.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$39.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$41.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$43.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$41.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$43.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$43.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$32.80
|
| Rate for Payer: Healthfirst Commercial |
$43.74
|
| Rate for Payer: Healthfirst Essential Plan |
$98.42
|
| Rate for Payer: Healthfirst Medicare Advantage |
$41.55
|
| Rate for Payer: Healthfirst QHP |
$43.74
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$30.62
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$43.74
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$37.18
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$30.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$43.74
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$32.80
|
| Rate for Payer: SOMOS Essential |
$32.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$43.74
|
|
|
PR ANT SGM IMAGING I&R SPECLR MICROSCOPY&NDTHL ALYS
|
Professional
|
Both
|
$84.46
|
|
|
Service Code
|
HCPCS 92286 26
|
| Min. Negotiated Rate |
$16.06 |
| Max. Negotiated Rate |
$97.65 |
| Rate for Payer: Amida Care Medicaid |
$97.65
|
| Rate for Payer: Cash Price |
$23.22
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$22.94
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$20.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$20.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$21.79
|
| Rate for Payer: Fidelis Medicare Advantage |
$22.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$21.79
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$22.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$22.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.20
|
| Rate for Payer: Healthfirst Commercial |
$22.94
|
| Rate for Payer: Healthfirst Essential Plan |
$51.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$21.79
|
| Rate for Payer: Healthfirst QHP |
$22.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$16.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$22.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$19.50
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$16.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$22.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$17.20
|
| Rate for Payer: SOMOS Essential |
$17.20
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$22.94
|
|
|
PR ANT SGM IMAGING W/I&R W/FLUOROSCEIN ANGRPH
|
Professional
|
Both
|
$614.74
|
|
|
Service Code
|
HCPCS 92287
|
| Min. Negotiated Rate |
$106.43 |
| Max. Negotiated Rate |
$342.09 |
| Rate for Payer: Cash Price |
$166.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$152.04
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$136.84
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$136.84
|
| Rate for Payer: Fidelis Essential Plan QHP |
$144.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$152.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$144.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$152.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$152.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$114.03
|
| Rate for Payer: Healthfirst Commercial |
$152.04
|
| Rate for Payer: Healthfirst Essential Plan |
$342.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$144.44
|
| Rate for Payer: Healthfirst QHP |
$152.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$106.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$152.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$129.23
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$106.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$152.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$114.03
|
| Rate for Payer: SOMOS Essential |
$114.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$152.04
|
|
