|
PR ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY
|
Professional
|
Both
|
$2,417.98
|
|
|
Service Code
|
HCPCS 29847
|
| Min. Negotiated Rate |
$456.71 |
| Max. Negotiated Rate |
$1,467.99 |
| Rate for Payer: Cash Price |
$655.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$652.44
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$587.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$587.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$619.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$652.44
|
| Rate for Payer: Fidelis Qualified Health Plan |
$619.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$652.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$652.44
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$489.33
|
| Rate for Payer: Healthfirst Commercial |
$652.44
|
| Rate for Payer: Healthfirst Essential Plan |
$1,467.99
|
| Rate for Payer: Healthfirst Medicare Advantage |
$619.82
|
| Rate for Payer: Healthfirst QHP |
$652.44
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$456.71
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$652.44
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$554.57
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$456.71
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$652.44
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$489.33
|
| Rate for Payer: SOMOS Essential |
$489.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$652.44
|
|
|
PR ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB
|
Professional
|
Both
|
$2,820.97
|
|
|
Service Code
|
HCPCS 27610
|
| Min. Negotiated Rate |
$534.85 |
| Max. Negotiated Rate |
$1,719.16 |
| Rate for Payer: Cash Price |
$766.95
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$764.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$687.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$687.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$725.87
|
| Rate for Payer: Fidelis Medicare Advantage |
$764.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$725.87
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$764.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$764.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$573.05
|
| Rate for Payer: Healthfirst Commercial |
$764.07
|
| Rate for Payer: Healthfirst Essential Plan |
$1,719.16
|
| Rate for Payer: Healthfirst Medicare Advantage |
$725.87
|
| Rate for Payer: Healthfirst QHP |
$764.07
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$534.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$764.07
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$649.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$534.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$764.07
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$573.05
|
| Rate for Payer: SOMOS Essential |
$573.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$764.07
|
|
|
PR ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH
|
Professional
|
Both
|
$1,513.65
|
|
|
Service Code
|
HCPCS 26100
|
| Min. Negotiated Rate |
$289.15 |
| Max. Negotiated Rate |
$929.41 |
| Rate for Payer: Cash Price |
$413.59
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$413.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$371.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$371.76
|
| Rate for Payer: Fidelis Essential Plan QHP |
$392.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$413.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$392.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$413.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$413.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$309.80
|
| Rate for Payer: Healthfirst Commercial |
$413.07
|
| Rate for Payer: Healthfirst Essential Plan |
$929.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$392.42
|
| Rate for Payer: Healthfirst QHP |
$413.07
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$289.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$413.07
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$351.11
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$289.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$413.07
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$309.80
|
| Rate for Payer: SOMOS Essential |
$309.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$413.07
|
|
|
PR ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH
|
Professional
|
Both
|
$1,445.47
|
|
|
Service Code
|
HCPCS 26110
|
| Min. Negotiated Rate |
$275.46 |
| Max. Negotiated Rate |
$885.42 |
| Rate for Payer: Cash Price |
$394.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$393.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$354.17
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$354.17
|
| Rate for Payer: Fidelis Essential Plan QHP |
$373.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$393.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$373.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$393.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$393.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$295.14
|
| Rate for Payer: Healthfirst Commercial |
$393.52
|
| Rate for Payer: Healthfirst Essential Plan |
$885.42
|
| Rate for Payer: Healthfirst Medicare Advantage |
$373.84
|
| Rate for Payer: Healthfirst QHP |
$393.52
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$275.46
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$393.52
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$334.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$275.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$393.52
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$295.14
|
| Rate for Payer: SOMOS Essential |
$295.14
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$393.52
|
|
|
PR ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH
|
Professional
|
Both
|
$1,527.02
|
|
|
Service Code
|
HCPCS 26105
|
| Min. Negotiated Rate |
$291.09 |
| Max. Negotiated Rate |
$935.64 |
| Rate for Payer: Cash Price |
$415.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$415.84
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$374.26
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$374.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$395.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$415.84
|
| Rate for Payer: Fidelis Qualified Health Plan |
$395.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$415.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$415.84
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$311.88
|
| Rate for Payer: Healthfirst Commercial |
$415.84
|
| Rate for Payer: Healthfirst Essential Plan |
$935.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$395.05
|
| Rate for Payer: Healthfirst QHP |
$415.84
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$291.09
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$415.84
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$353.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$291.09
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$415.84
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$311.88
|
| Rate for Payer: SOMOS Essential |
$311.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$415.84
|
|
|
PR ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE
|
Professional
|
Both
|
$2,726.05
|
|
|
Service Code
|
HCPCS 25107
|
| Min. Negotiated Rate |
$520.95 |
| Max. Negotiated Rate |
$1,674.47 |
| Rate for Payer: Cash Price |
$742.91
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$744.21
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$669.79
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$669.79
|
| Rate for Payer: Fidelis Essential Plan QHP |
$707.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$744.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$707.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$744.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$744.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$558.16
|
| Rate for Payer: Healthfirst Commercial |
$744.21
|
| Rate for Payer: Healthfirst Essential Plan |
$1,674.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$707.00
|
| Rate for Payer: Healthfirst QHP |
$744.21
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$520.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$744.21
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$632.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$520.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$744.21
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$558.16
|
| Rate for Payer: SOMOS Essential |
$558.16
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$744.21
|
|
|
PR ARTHROTOMY ELBOW W/SYNOVECTOMY
|
Professional
|
Both
|
$2,726.40
|
|
|
Service Code
|
HCPCS 24102
|
| Min. Negotiated Rate |
$516.60 |
| Max. Negotiated Rate |
$1,660.50 |
| Rate for Payer: Cash Price |
$741.02
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$738.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$664.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$664.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$701.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$738.00
|
| Rate for Payer: Fidelis Qualified Health Plan |
$701.10
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$738.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$738.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$553.50
|
| Rate for Payer: Healthfirst Commercial |
$738.00
|
| Rate for Payer: Healthfirst Essential Plan |
$1,660.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$701.10
|
| Rate for Payer: Healthfirst QHP |
$738.00
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$516.60
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$738.00
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$627.30
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$516.60
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$738.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$553.50
|
| Rate for Payer: SOMOS Essential |
$553.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$738.00
|
|
|
PR ARTHROTOMY ELBOW W/SYNOVIAL BIOPSY ONLY
|
Professional
|
Both
|
$1,871.49
|
|
|
Service Code
|
HCPCS 24100
|
| Min. Negotiated Rate |
$355.40 |
| Max. Negotiated Rate |
$1,142.35 |
| Rate for Payer: Cash Price |
$510.33
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$507.71
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$456.94
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$456.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$482.32
|
| Rate for Payer: Fidelis Medicare Advantage |
$507.71
|
| Rate for Payer: Fidelis Qualified Health Plan |
$482.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$507.71
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$507.71
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$380.78
|
| Rate for Payer: Healthfirst Commercial |
$507.71
|
| Rate for Payer: Healthfirst Essential Plan |
$1,142.35
|
| Rate for Payer: Healthfirst Medicare Advantage |
$482.32
|
| Rate for Payer: Healthfirst QHP |
$507.71
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$355.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$507.71
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$431.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$355.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$507.71
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$380.78
|
| Rate for Payer: SOMOS Essential |
$380.78
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$507.71
|
|
|
PR ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY
|
Professional
|
Both
|
$2,255.61
|
|
|
Service Code
|
HCPCS 23100
|
| Min. Negotiated Rate |
$427.54 |
| Max. Negotiated Rate |
$1,374.23 |
| Rate for Payer: Cash Price |
$612.61
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$610.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$549.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$549.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$580.23
|
| Rate for Payer: Fidelis Medicare Advantage |
$610.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$580.23
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$610.77
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$610.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$458.08
|
| Rate for Payer: Healthfirst Commercial |
$610.77
|
| Rate for Payer: Healthfirst Essential Plan |
$1,374.23
|
| Rate for Payer: Healthfirst Medicare Advantage |
$580.23
|
| Rate for Payer: Healthfirst QHP |
$610.77
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$427.54
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$610.77
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$519.15
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$427.54
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$610.77
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$458.08
|
| Rate for Payer: SOMOS Essential |
$458.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$610.77
|
|
|
PR ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB
|
Professional
|
Both
|
$3,181.15
|
|
|
Service Code
|
HCPCS 23040
|
| Min. Negotiated Rate |
$598.33 |
| Max. Negotiated Rate |
$1,923.19 |
| Rate for Payer: Cash Price |
$859.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$854.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$769.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$769.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$812.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$854.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$812.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$854.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$854.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$641.06
|
| Rate for Payer: Healthfirst Commercial |
$854.75
|
| Rate for Payer: Healthfirst Essential Plan |
$1,923.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$812.01
|
| Rate for Payer: Healthfirst QHP |
$854.75
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$598.33
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$854.75
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$726.54
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$598.33
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$854.75
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$641.06
|
| Rate for Payer: SOMOS Essential |
$641.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$854.75
|
|
|
PR ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY
|
Professional
|
Both
|
$4,295.62
|
|
|
Service Code
|
HCPCS 27033
|
| Min. Negotiated Rate |
$808.53 |
| Max. Negotiated Rate |
$2,598.86 |
| Rate for Payer: Cash Price |
$1,158.09
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,155.05
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,039.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,039.55
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,097.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,155.05
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,097.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,155.05
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,155.05
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$866.29
|
| Rate for Payer: Healthfirst Commercial |
$1,155.05
|
| Rate for Payer: Healthfirst Essential Plan |
$2,598.86
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,097.30
|
| Rate for Payer: Healthfirst QHP |
$1,155.05
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$808.53
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,155.05
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$981.79
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$808.53
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,155.05
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$866.29
|
| Rate for Payer: SOMOS Essential |
$866.29
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,155.05
|
|
|
PR ARTHROTOMY HIP W/DRAINAGE
|
Professional
|
Both
|
$4,142.81
|
|
|
Service Code
|
HCPCS 27030
|
| Min. Negotiated Rate |
$777.79 |
| Max. Negotiated Rate |
$2,500.04 |
| Rate for Payer: Cash Price |
$1,116.61
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,111.13
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,000.02
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,000.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,055.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,111.13
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,055.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,111.13
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,111.13
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$833.35
|
| Rate for Payer: Healthfirst Commercial |
$1,111.13
|
| Rate for Payer: Healthfirst Essential Plan |
$2,500.04
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,055.57
|
| Rate for Payer: Healthfirst QHP |
$1,111.13
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$777.79
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,111.13
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$944.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$777.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,111.13
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$833.35
|
| Rate for Payer: SOMOS Essential |
$833.35
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,111.13
|
|
|
PR ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY
|
Professional
|
Both
|
$1,882.09
|
|
|
Service Code
|
HCPCS 27330
|
| Min. Negotiated Rate |
$357.34 |
| Max. Negotiated Rate |
$1,148.58 |
| Rate for Payer: Cash Price |
$513.13
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$510.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$459.43
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$459.43
|
| Rate for Payer: Fidelis Essential Plan QHP |
$484.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$510.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$484.96
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$510.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$510.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$382.86
|
| Rate for Payer: Healthfirst Commercial |
$510.48
|
| Rate for Payer: Healthfirst Essential Plan |
$1,148.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$484.96
|
| Rate for Payer: Healthfirst QHP |
$510.48
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$357.34
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$510.48
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$433.91
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$357.34
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$510.48
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$382.86
|
| Rate for Payer: SOMOS Essential |
$382.86
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$510.48
|
|
|
PR ARTHROTOMY TEMPOROMANDIBULAR JOINT
|
Professional
|
Both
|
$3,131.00
|
|
|
Service Code
|
HCPCS 21010
|
| Min. Negotiated Rate |
$593.35 |
| Max. Negotiated Rate |
$1,907.19 |
| Rate for Payer: Cash Price |
$850.67
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$847.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$762.88
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$762.88
|
| Rate for Payer: Fidelis Essential Plan QHP |
$805.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$847.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$805.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$847.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$847.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$635.73
|
| Rate for Payer: Healthfirst Commercial |
$847.64
|
| Rate for Payer: Healthfirst Essential Plan |
$1,907.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$805.26
|
| Rate for Payer: Healthfirst QHP |
$847.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$593.35
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$847.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$720.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$593.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$847.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$635.73
|
| Rate for Payer: SOMOS Essential |
$635.73
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$847.64
|
|
|
PR ARTHROTOMY W/BIOPSY HIP JOINT
|
Professional
|
Both
|
$2,573.13
|
|
|
Service Code
|
HCPCS 27052
|
| Min. Negotiated Rate |
$487.88 |
| Max. Negotiated Rate |
$1,568.18 |
| Rate for Payer: Cash Price |
$698.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$696.97
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$627.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$627.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$662.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$696.97
|
| Rate for Payer: Fidelis Qualified Health Plan |
$662.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$696.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$696.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$522.73
|
| Rate for Payer: Healthfirst Commercial |
$696.97
|
| Rate for Payer: Healthfirst Essential Plan |
$1,568.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$662.12
|
| Rate for Payer: Healthfirst QHP |
$696.97
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$487.88
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$696.97
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$592.42
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$487.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$696.97
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$522.73
|
| Rate for Payer: SOMOS Essential |
$522.73
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$696.97
|
|
|
PR ARTHROTOMY W/BIOPSY SACROILIAC JOINT
|
Professional
|
Both
|
$1,803.80
|
|
|
Service Code
|
HCPCS 27050
|
| Min. Negotiated Rate |
$344.19 |
| Max. Negotiated Rate |
$1,106.33 |
| Rate for Payer: Cash Price |
$492.24
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$491.70
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$442.53
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$442.53
|
| Rate for Payer: Fidelis Essential Plan QHP |
$467.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$491.70
|
| Rate for Payer: Fidelis Qualified Health Plan |
$467.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$491.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$491.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$368.77
|
| Rate for Payer: Healthfirst Commercial |
$491.70
|
| Rate for Payer: Healthfirst Essential Plan |
$1,106.33
|
| Rate for Payer: Healthfirst Medicare Advantage |
$467.12
|
| Rate for Payer: Healthfirst QHP |
$491.70
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$344.19
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$491.70
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$417.94
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$344.19
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$491.70
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$368.77
|
| Rate for Payer: SOMOS Essential |
$368.77
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$491.70
|
|
|
PR ARTHROTOMY W/MENISCUS REPAIR KNEE
|
Professional
|
Both
|
$2,861.39
|
|
|
Service Code
|
HCPCS 27403
|
| Min. Negotiated Rate |
$541.44 |
| Max. Negotiated Rate |
$1,740.35 |
| Rate for Payer: Cash Price |
$776.16
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$773.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$696.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$696.14
|
| Rate for Payer: Fidelis Essential Plan QHP |
$734.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$773.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$734.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$773.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$773.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$580.12
|
| Rate for Payer: Healthfirst Commercial |
$773.49
|
| Rate for Payer: Healthfirst Essential Plan |
$1,740.35
|
| Rate for Payer: Healthfirst Medicare Advantage |
$734.82
|
| Rate for Payer: Healthfirst QHP |
$773.49
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$541.44
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$773.49
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$657.47
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$541.44
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$773.49
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$580.12
|
| Rate for Payer: SOMOS Essential |
$580.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$773.49
|
|
|
PR ARTHROTOMY WRIST JOINT WITH BIOPSY
|
Professional
|
Both
|
$1,560.44
|
|
|
Service Code
|
HCPCS 25100
|
| Min. Negotiated Rate |
$297.08 |
| Max. Negotiated Rate |
$954.90 |
| Rate for Payer: Cash Price |
$425.29
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$424.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$381.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$381.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$403.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$424.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$403.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$424.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$424.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$318.30
|
| Rate for Payer: Healthfirst Commercial |
$424.40
|
| Rate for Payer: Healthfirst Essential Plan |
$954.90
|
| Rate for Payer: Healthfirst Medicare Advantage |
$403.18
|
| Rate for Payer: Healthfirst QHP |
$424.40
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$297.08
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$424.40
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$360.74
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$297.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$424.40
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$318.30
|
| Rate for Payer: SOMOS Essential |
$318.30
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$424.40
|
|
|
PR ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY
|
Professional
|
Both
|
$2,164.30
|
|
|
Service Code
|
HCPCS 25105
|
| Min. Negotiated Rate |
$410.94 |
| Max. Negotiated Rate |
$1,320.88 |
| Rate for Payer: Cash Price |
$587.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$587.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$528.35
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$528.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$557.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$587.06
|
| Rate for Payer: Fidelis Qualified Health Plan |
$557.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$587.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$587.06
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$440.30
|
| Rate for Payer: Healthfirst Commercial |
$587.06
|
| Rate for Payer: Healthfirst Essential Plan |
$1,320.88
|
| Rate for Payer: Healthfirst Medicare Advantage |
$557.71
|
| Rate for Payer: Healthfirst QHP |
$587.06
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$410.94
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$587.06
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$499.00
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$410.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$587.06
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$440.30
|
| Rate for Payer: SOMOS Essential |
$440.30
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$587.06
|
|
|
PR ARTHROTOMY W/SYNOVECTOMY ANKLE
|
Professional
|
Both
|
$2,473.45
|
|
|
Service Code
|
HCPCS 27625
|
| Min. Negotiated Rate |
$467.60 |
| Max. Negotiated Rate |
$1,503.00 |
| Rate for Payer: Cash Price |
$674.48
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$668.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$601.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$601.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$634.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$668.00
|
| Rate for Payer: Fidelis Qualified Health Plan |
$634.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$668.00
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$668.00
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$501.00
|
| Rate for Payer: Healthfirst Commercial |
$668.00
|
| Rate for Payer: Healthfirst Essential Plan |
$1,503.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$634.60
|
| Rate for Payer: Healthfirst QHP |
$668.00
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$467.60
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$668.00
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$567.80
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$467.60
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$668.00
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$501.00
|
| Rate for Payer: SOMOS Essential |
$501.00
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$668.00
|
|
|
PR ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY
|
Professional
|
Both
|
$2,637.71
|
|
|
Service Code
|
HCPCS 27626
|
| Min. Negotiated Rate |
$502.77 |
| Max. Negotiated Rate |
$1,616.04 |
| Rate for Payer: Cash Price |
$732.08
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$718.24
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$646.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$646.42
|
| Rate for Payer: Fidelis Essential Plan QHP |
$682.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$718.24
|
| Rate for Payer: Fidelis Qualified Health Plan |
$682.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$718.24
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$718.24
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$538.68
|
| Rate for Payer: Healthfirst Commercial |
$718.24
|
| Rate for Payer: Healthfirst Essential Plan |
$1,616.04
|
| Rate for Payer: Healthfirst Medicare Advantage |
$682.33
|
| Rate for Payer: Healthfirst QHP |
$718.24
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$502.77
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$718.24
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$610.50
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$502.77
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$718.24
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$538.68
|
| Rate for Payer: SOMOS Essential |
$538.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$718.24
|
|
|
PR ARTHROTOMY W/SYNOVECTOMY HIP JOINT
|
Professional
|
Both
|
$3,062.57
|
|
|
Service Code
|
HCPCS 27054
|
| Min. Negotiated Rate |
$576.94 |
| Max. Negotiated Rate |
$1,854.45 |
| Rate for Payer: Cash Price |
$826.64
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$824.20
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$741.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$741.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$782.99
|
| Rate for Payer: Fidelis Medicare Advantage |
$824.20
|
| Rate for Payer: Fidelis Qualified Health Plan |
$782.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$824.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$824.20
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$618.15
|
| Rate for Payer: Healthfirst Commercial |
$824.20
|
| Rate for Payer: Healthfirst Essential Plan |
$1,854.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$782.99
|
| Rate for Payer: Healthfirst QHP |
$824.20
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$576.94
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$824.20
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$700.57
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$576.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$824.20
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$618.15
|
| Rate for Payer: SOMOS Essential |
$618.15
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$824.20
|
|
|
PR ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR
|
Professional
|
Both
|
$3,053.02
|
|
|
Service Code
|
HCPCS 27334
|
| Min. Negotiated Rate |
$576.30 |
| Max. Negotiated Rate |
$1,852.38 |
| Rate for Payer: Cash Price |
$824.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$823.28
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$740.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$740.95
|
| Rate for Payer: Fidelis Essential Plan QHP |
$782.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$823.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$782.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$823.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$823.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$617.46
|
| Rate for Payer: Healthfirst Commercial |
$823.28
|
| Rate for Payer: Healthfirst Essential Plan |
$1,852.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$782.12
|
| Rate for Payer: Healthfirst QHP |
$823.28
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$576.30
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$823.28
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$699.79
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$576.30
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$823.28
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$617.46
|
| Rate for Payer: SOMOS Essential |
$617.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$823.28
|
|
|
PR ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT
|
Professional
|
Both
|
$5,667.59
|
|
|
Service Code
|
HCPCS 27130
|
| Min. Negotiated Rate |
$1,062.09 |
| Max. Negotiated Rate |
$3,413.86 |
| Rate for Payer: Cash Price |
$1,525.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,517.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,365.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,365.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,441.41
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,517.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,441.41
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,517.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,517.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,137.95
|
| Rate for Payer: Healthfirst Commercial |
$1,517.27
|
| Rate for Payer: Healthfirst Essential Plan |
$3,413.86
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,441.41
|
| Rate for Payer: Healthfirst QHP |
$1,517.27
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,062.09
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,517.27
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,289.68
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,062.09
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,517.27
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,137.95
|
| Rate for Payer: SOMOS Essential |
$1,137.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,517.27
|
|
|
PR ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM
|
Professional
|
Both
|
$6,370.70
|
|
|
Service Code
|
HCPCS 24363
|
| Min. Negotiated Rate |
$1,196.15 |
| Max. Negotiated Rate |
$3,844.76 |
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,708.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,537.90
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,537.90
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,623.34
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,708.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,623.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,708.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,708.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,281.59
|
| Rate for Payer: Healthfirst Commercial |
$1,708.78
|
| Rate for Payer: Healthfirst Essential Plan |
$3,844.76
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,623.34
|
| Rate for Payer: Healthfirst QHP |
$1,708.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,196.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,708.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,452.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,196.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,708.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,281.59
|
| Rate for Payer: SOMOS Essential |
$1,281.59
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,708.78
|
|
