|
PR BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE
|
Professional
|
Both
|
$443.63
|
|
|
Service Code
|
HCPCS 92524
|
| Min. Negotiated Rate |
$50.97 |
| Max. Negotiated Rate |
$271.94 |
| Rate for Payer: Amida Care Medicaid |
$50.97
|
| Rate for Payer: Cash Price |
$122.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$120.86
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$108.77
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$108.77
|
| Rate for Payer: Fidelis Essential Plan QHP |
$114.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$120.86
|
| Rate for Payer: Fidelis Qualified Health Plan |
$114.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$120.86
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$120.86
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$90.64
|
| Rate for Payer: Healthfirst Commercial |
$120.86
|
| Rate for Payer: Healthfirst Essential Plan |
$271.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$114.82
|
| Rate for Payer: Healthfirst QHP |
$120.86
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$84.60
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$120.86
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$102.73
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$84.60
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$120.86
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$90.64
|
| Rate for Payer: SOMOS Essential |
$90.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$120.86
|
|
|
PR BEHAVIOR COUNSEL OBESITY 15M
|
Professional
|
Both
|
$94.61
|
|
|
Service Code
|
HCPCS G0447
|
| Min. Negotiated Rate |
$23.26 |
| Max. Negotiated Rate |
$74.77 |
| Rate for Payer: Cash Price |
$25.04
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$33.23
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$29.91
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$29.91
|
| Rate for Payer: Fidelis Essential Plan QHP |
$31.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$33.23
|
| Rate for Payer: Fidelis Qualified Health Plan |
$31.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$33.23
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$33.23
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24.92
|
| Rate for Payer: Healthfirst Commercial |
$33.23
|
| Rate for Payer: Healthfirst Essential Plan |
$74.77
|
| Rate for Payer: Healthfirst Medicare Advantage |
$31.57
|
| Rate for Payer: Healthfirst QHP |
$33.23
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$23.26
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$33.23
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$28.25
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$23.26
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$33.23
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24.92
|
| Rate for Payer: SOMOS Essential |
$24.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$33.23
|
|
|
PR BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT
|
Professional
|
Both
|
$169.68
|
|
|
Service Code
|
HCPCS 90912
|
| Min. Negotiated Rate |
$32.13 |
| Max. Negotiated Rate |
$103.28 |
| Rate for Payer: Cash Price |
$46.69
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$45.90
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$41.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$41.31
|
| Rate for Payer: Fidelis Essential Plan QHP |
$43.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$45.90
|
| Rate for Payer: Fidelis Qualified Health Plan |
$43.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$45.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$45.90
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$34.42
|
| Rate for Payer: Healthfirst Commercial |
$45.90
|
| Rate for Payer: Healthfirst Essential Plan |
$103.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$43.60
|
| Rate for Payer: Healthfirst QHP |
$45.90
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$32.13
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$45.90
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$39.02
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$32.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$45.90
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$34.42
|
| Rate for Payer: SOMOS Essential |
$34.42
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$45.90
|
|
|
PR BFB TRAING W/EMG&/MANOMETRY EA ADDL 15 MIN CNTCT
|
Professional
|
Both
|
$99.44
|
|
|
Service Code
|
HCPCS 90913
|
| Min. Negotiated Rate |
$18.25 |
| Max. Negotiated Rate |
$58.66 |
| Rate for Payer: Cash Price |
$26.39
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$26.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$23.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$24.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$26.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$26.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$26.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19.55
|
| Rate for Payer: Healthfirst Commercial |
$26.07
|
| Rate for Payer: Healthfirst Essential Plan |
$58.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$24.77
|
| Rate for Payer: Healthfirst QHP |
$26.07
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$18.25
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$26.07
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$22.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$18.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$26.07
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19.55
|
| Rate for Payer: SOMOS Essential |
$19.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$26.07
|
|
|
PR BICORONAL TRANSZYGMTC&/LEFORT I W/O BONE GRFT
|
Professional
|
Both
|
$11,971.12
|
|
|
Service Code
|
HCPCS 61586
|
| Min. Negotiated Rate |
$2,173.14 |
| Max. Negotiated Rate |
$6,985.08 |
| Rate for Payer: Cash Price |
$3,162.64
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,104.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,794.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,794.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,949.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,104.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,949.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,104.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,104.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,328.36
|
| Rate for Payer: Healthfirst Commercial |
$3,104.48
|
| Rate for Payer: Healthfirst Essential Plan |
$6,985.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,949.26
|
| Rate for Payer: Healthfirst QHP |
$3,104.48
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,173.14
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,104.48
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,638.81
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,173.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,104.48
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,328.36
|
| Rate for Payer: SOMOS Essential |
$2,328.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,104.48
|
|
|
PR BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH
|
Professional
|
Both
|
$1,151.92
|
|
|
Service Code
|
HCPCS 47552
|
| Min. Negotiated Rate |
$217.21 |
| Max. Negotiated Rate |
$698.17 |
| Rate for Payer: Cash Price |
$310.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$310.30
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$279.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$279.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$294.79
|
| Rate for Payer: Fidelis Medicare Advantage |
$310.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$294.79
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$310.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$310.30
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$232.72
|
| Rate for Payer: Healthfirst Commercial |
$310.30
|
| Rate for Payer: Healthfirst Essential Plan |
$698.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$294.79
|
| Rate for Payer: Healthfirst QHP |
$310.30
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$217.21
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$310.30
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$263.75
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$217.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$310.30
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$232.72
|
| Rate for Payer: SOMOS Essential |
$232.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$310.30
|
|
|
PR BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS
|
Professional
|
Both
|
$1,878.70
|
|
|
Service Code
|
HCPCS 47554
|
| Min. Negotiated Rate |
$352.32 |
| Max. Negotiated Rate |
$1,132.45 |
| Rate for Payer: Cash Price |
$505.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$503.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$452.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$452.98
|
| Rate for Payer: Fidelis Essential Plan QHP |
$478.14
|
| Rate for Payer: Fidelis Medicare Advantage |
$503.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$478.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$503.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$503.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$377.48
|
| Rate for Payer: Healthfirst Commercial |
$503.31
|
| Rate for Payer: Healthfirst Essential Plan |
$1,132.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$478.14
|
| Rate for Payer: Healthfirst QHP |
$503.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$352.32
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$503.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$427.81
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$352.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$503.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$377.48
|
| Rate for Payer: SOMOS Essential |
$377.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$503.31
|
|
|
PR BILIARY NDSC INTRAOPERATIVE
|
Professional
|
Both
|
$736.26
|
|
|
Service Code
|
HCPCS 47550
|
| Min. Negotiated Rate |
$133.98 |
| Max. Negotiated Rate |
$430.65 |
| Rate for Payer: Cash Price |
$193.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$191.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$172.26
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$172.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$181.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$191.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$181.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$191.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$191.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$143.55
|
| Rate for Payer: Healthfirst Commercial |
$191.40
|
| Rate for Payer: Healthfirst Essential Plan |
$430.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$181.83
|
| Rate for Payer: Healthfirst QHP |
$191.40
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$133.98
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$191.40
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$162.69
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$133.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$191.40
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$143.55
|
| Rate for Payer: SOMOS Essential |
$143.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$191.40
|
|
|
PR BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT
|
Professional
|
Both
|
$1,556.84
|
|
|
Service Code
|
HCPCS 47556
|
| Min. Negotiated Rate |
$292.21 |
| Max. Negotiated Rate |
$939.24 |
| Rate for Payer: Cash Price |
$419.34
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$417.44
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$375.70
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$375.70
|
| Rate for Payer: Fidelis Essential Plan QHP |
$396.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$417.44
|
| Rate for Payer: Fidelis Qualified Health Plan |
$396.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$417.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$417.44
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$313.08
|
| Rate for Payer: Healthfirst Commercial |
$417.44
|
| Rate for Payer: Healthfirst Essential Plan |
$939.24
|
| Rate for Payer: Healthfirst Medicare Advantage |
$396.57
|
| Rate for Payer: Healthfirst QHP |
$417.44
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$292.21
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$417.44
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$354.82
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$292.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$417.44
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$313.08
|
| Rate for Payer: SOMOS Essential |
$313.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$417.44
|
|
|
PR BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE
|
Professional
|
Both
|
$1,155.70
|
|
|
Service Code
|
HCPCS 47553
|
| Min. Negotiated Rate |
$217.77 |
| Max. Negotiated Rate |
$699.98 |
| Rate for Payer: Cash Price |
$310.37
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$311.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$279.99
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$279.99
|
| Rate for Payer: Fidelis Essential Plan QHP |
$295.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$311.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$295.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$311.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$311.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$233.32
|
| Rate for Payer: Healthfirst Commercial |
$311.10
|
| Rate for Payer: Healthfirst Essential Plan |
$699.98
|
| Rate for Payer: Healthfirst Medicare Advantage |
$295.55
|
| Rate for Payer: Healthfirst QHP |
$311.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$217.77
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$311.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$264.44
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$217.77
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$311.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$233.32
|
| Rate for Payer: SOMOS Essential |
$233.32
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$311.10
|
|
|
PR BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT
|
Professional
|
Both
|
$1,374.31
|
|
|
Service Code
|
HCPCS 47555
|
| Min. Negotiated Rate |
$257.85 |
| Max. Negotiated Rate |
$828.79 |
| Rate for Payer: Cash Price |
$370.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$368.35
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$331.51
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$331.51
|
| Rate for Payer: Fidelis Essential Plan QHP |
$349.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$368.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$349.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$368.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$368.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$276.26
|
| Rate for Payer: Healthfirst Commercial |
$368.35
|
| Rate for Payer: Healthfirst Essential Plan |
$828.79
|
| Rate for Payer: Healthfirst Medicare Advantage |
$349.93
|
| Rate for Payer: Healthfirst QHP |
$368.35
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$257.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$368.35
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$313.10
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$257.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$368.35
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$276.26
|
| Rate for Payer: SOMOS Essential |
$276.26
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$368.35
|
|
|
PR BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE
|
Professional
|
Both
|
$38.22
|
|
|
Service Code
|
HCPCS 92504
|
| Min. Negotiated Rate |
$7.22 |
| Max. Negotiated Rate |
$23.20 |
| Rate for Payer: Cash Price |
$10.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$10.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$9.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$9.79
|
| Rate for Payer: Fidelis Medicare Advantage |
$10.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$9.79
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.73
|
| Rate for Payer: Healthfirst Commercial |
$10.31
|
| Rate for Payer: Healthfirst Essential Plan |
$23.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.79
|
| Rate for Payer: Healthfirst QHP |
$10.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$7.22
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$10.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$8.76
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$7.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$10.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$7.73
|
| Rate for Payer: SOMOS Essential |
$7.73
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$10.31
|
|
|
PR BIOFEEDBACK TRAINING ANY MODALITY
|
Professional
|
Both
|
$74.20
|
|
|
Service Code
|
HCPCS 90901
|
| Min. Negotiated Rate |
$14.55 |
| Max. Negotiated Rate |
$46.78 |
| Rate for Payer: Cash Price |
$21.05
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$20.79
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$18.71
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$18.71
|
| Rate for Payer: Fidelis Essential Plan QHP |
$19.75
|
| Rate for Payer: Fidelis Medicare Advantage |
$20.79
|
| Rate for Payer: Fidelis Qualified Health Plan |
$19.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$20.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$20.79
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$15.59
|
| Rate for Payer: Healthfirst Commercial |
$20.79
|
| Rate for Payer: Healthfirst Essential Plan |
$46.78
|
| Rate for Payer: Healthfirst Medicare Advantage |
$19.75
|
| Rate for Payer: Healthfirst QHP |
$20.79
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$14.55
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$20.79
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$17.67
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$14.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$20.79
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$15.59
|
| Rate for Payer: SOMOS Essential |
$15.59
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$20.79
|
|
|
PR BIOMPEDANCE-DERIVED PHYSIOLOGIC CV ANALYSIS
|
Professional
|
Both
|
$114.87
|
|
|
Service Code
|
HCPCS 93701
|
| Min. Negotiated Rate |
$21.62 |
| Max. Negotiated Rate |
$69.50 |
| Rate for Payer: Amida Care Medicaid |
$31.06
|
| Rate for Payer: Cash Price |
$32.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$30.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$27.80
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$27.80
|
| Rate for Payer: Fidelis Essential Plan QHP |
$29.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$30.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$29.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$30.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$30.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23.17
|
| Rate for Payer: Healthfirst Commercial |
$30.89
|
| Rate for Payer: Healthfirst Essential Plan |
$69.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$29.35
|
| Rate for Payer: Healthfirst QHP |
$30.89
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$21.62
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$30.89
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$26.26
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$21.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$30.89
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$23.17
|
| Rate for Payer: SOMOS Essential |
$23.17
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$30.89
|
|
|
PR BIOPSY BONE OPEN DEEP
|
Professional
|
Both
|
$1,493.31
|
|
|
Service Code
|
HCPCS 20245
|
| Min. Negotiated Rate |
$277.07 |
| Max. Negotiated Rate |
$890.60 |
| Rate for Payer: Cash Price |
$400.68
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$395.82
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$356.24
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$356.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$376.03
|
| Rate for Payer: Fidelis Medicare Advantage |
$395.82
|
| Rate for Payer: Fidelis Qualified Health Plan |
$376.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$395.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$395.82
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$296.87
|
| Rate for Payer: Healthfirst Commercial |
$395.82
|
| Rate for Payer: Healthfirst Essential Plan |
$890.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$376.03
|
| Rate for Payer: Healthfirst QHP |
$395.82
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$277.07
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$395.82
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$336.45
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$277.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$395.82
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$296.87
|
| Rate for Payer: SOMOS Essential |
$296.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$395.82
|
|
|
PR BIOPSY BONE OPEN SUPERFICIAL
|
Professional
|
Both
|
$584.50
|
|
|
Service Code
|
HCPCS 20240
|
| Min. Negotiated Rate |
$110.81 |
| Max. Negotiated Rate |
$356.18 |
| Rate for Payer: Cash Price |
$159.69
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$158.30
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$142.47
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$142.47
|
| Rate for Payer: Fidelis Essential Plan QHP |
$150.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$158.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$150.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$158.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$158.30
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$118.72
|
| Rate for Payer: Healthfirst Commercial |
$158.30
|
| Rate for Payer: Healthfirst Essential Plan |
$356.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$150.38
|
| Rate for Payer: Healthfirst QHP |
$158.30
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$110.81
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$158.30
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$134.56
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$110.81
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$158.30
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$118.72
|
| Rate for Payer: SOMOS Essential |
$118.72
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$158.30
|
|
|
PR BIOPSY BONE TROCAR/NEEDLE DEEP
|
Professional
|
Both
|
$534.84
|
|
|
Service Code
|
HCPCS 20225
|
| Min. Negotiated Rate |
$101.14 |
| Max. Negotiated Rate |
$325.10 |
| Rate for Payer: Cash Price |
$144.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$144.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$130.04
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$130.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$137.27
|
| Rate for Payer: Fidelis Medicare Advantage |
$144.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$137.27
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$144.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$144.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$108.37
|
| Rate for Payer: Healthfirst Commercial |
$144.49
|
| Rate for Payer: Healthfirst Essential Plan |
$325.10
|
| Rate for Payer: Healthfirst Medicare Advantage |
$137.27
|
| Rate for Payer: Healthfirst QHP |
$144.49
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$101.14
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$144.49
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$122.82
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$101.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$144.49
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$108.37
|
| Rate for Payer: SOMOS Essential |
$108.37
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$144.49
|
|
|
PR BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL
|
Professional
|
Both
|
$363.86
|
|
|
Service Code
|
HCPCS 20220
|
| Min. Negotiated Rate |
$67.91 |
| Max. Negotiated Rate |
$218.27 |
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$97.01
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$87.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$87.31
|
| Rate for Payer: Fidelis Essential Plan QHP |
$92.16
|
| Rate for Payer: Fidelis Medicare Advantage |
$97.01
|
| Rate for Payer: Fidelis Qualified Health Plan |
$92.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$97.01
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$97.01
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$72.76
|
| Rate for Payer: Healthfirst Commercial |
$97.01
|
| Rate for Payer: Healthfirst Essential Plan |
$218.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$92.16
|
| Rate for Payer: Healthfirst QHP |
$97.01
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$67.91
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$97.01
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$82.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$67.91
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$97.01
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$72.76
|
| Rate for Payer: SOMOS Essential |
$72.76
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$97.01
|
|
|
PR BIOPSY BREAST OPEN INCISIONAL
|
Professional
|
Both
|
$1,004.82
|
|
|
Service Code
|
HCPCS 19101
|
| Min. Negotiated Rate |
$187.50 |
| Max. Negotiated Rate |
$602.66 |
| Rate for Payer: Cash Price |
$268.95
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$267.85
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$241.06
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$241.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$254.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$267.85
|
| Rate for Payer: Fidelis Qualified Health Plan |
$254.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$267.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$267.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$200.89
|
| Rate for Payer: Healthfirst Commercial |
$267.85
|
| Rate for Payer: Healthfirst Essential Plan |
$602.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$254.46
|
| Rate for Payer: Healthfirst QHP |
$267.85
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$187.50
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$267.85
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$227.67
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$187.50
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$267.85
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$200.89
|
| Rate for Payer: SOMOS Essential |
$200.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$267.85
|
|
|
PR BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX
|
Professional
|
Both
|
$323.05
|
|
|
Service Code
|
HCPCS 57500
|
| Min. Negotiated Rate |
$61.23 |
| Max. Negotiated Rate |
$196.81 |
| Rate for Payer: Cash Price |
$88.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$87.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$78.72
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$78.72
|
| Rate for Payer: Fidelis Essential Plan QHP |
$83.10
|
| Rate for Payer: Fidelis Medicare Advantage |
$87.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$83.10
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$87.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$87.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$65.60
|
| Rate for Payer: Healthfirst Commercial |
$87.47
|
| Rate for Payer: Healthfirst Essential Plan |
$196.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$83.10
|
| Rate for Payer: Healthfirst QHP |
$87.47
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$61.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$87.47
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$74.35
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$61.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$87.47
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$65.60
|
| Rate for Payer: SOMOS Essential |
$65.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$87.47
|
|
|
PR BIOPSY CONJUNCTIVA
|
Professional
|
Both
|
$391.79
|
|
|
Service Code
|
HCPCS 68100
|
| Min. Negotiated Rate |
$75.52 |
| Max. Negotiated Rate |
$242.73 |
| Rate for Payer: Cash Price |
$107.79
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$107.88
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$97.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$97.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$102.49
|
| Rate for Payer: Fidelis Medicare Advantage |
$107.88
|
| Rate for Payer: Fidelis Qualified Health Plan |
$102.49
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$107.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$107.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$80.91
|
| Rate for Payer: Healthfirst Commercial |
$107.88
|
| Rate for Payer: Healthfirst Essential Plan |
$242.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$102.49
|
| Rate for Payer: Healthfirst QHP |
$107.88
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$75.52
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$107.88
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$91.70
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$75.52
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$107.88
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$80.91
|
| Rate for Payer: SOMOS Essential |
$80.91
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$107.88
|
|
|
PR BIOPSY CORNEA
|
Professional
|
Both
|
$416.89
|
|
|
Service Code
|
HCPCS 65410
|
| Min. Negotiated Rate |
$80.75 |
| Max. Negotiated Rate |
$259.54 |
| Rate for Payer: Cash Price |
$115.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$115.35
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$103.81
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$103.81
|
| Rate for Payer: Fidelis Essential Plan QHP |
$109.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$115.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$109.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$115.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$115.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$86.51
|
| Rate for Payer: Healthfirst Commercial |
$115.35
|
| Rate for Payer: Healthfirst Essential Plan |
$259.54
|
| Rate for Payer: Healthfirst Medicare Advantage |
$109.58
|
| Rate for Payer: Healthfirst QHP |
$115.35
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$80.75
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$115.35
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$98.05
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$80.75
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$115.35
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$86.51
|
| Rate for Payer: SOMOS Essential |
$86.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$115.35
|
|
|
PR BIOPSY EPIDIDYMIS NEEDLE
|
Professional
|
Both
|
$518.07
|
|
|
Service Code
|
HCPCS 54800
|
| Min. Negotiated Rate |
$99.27 |
| Max. Negotiated Rate |
$319.10 |
| Rate for Payer: Cash Price |
$143.01
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$141.82
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$127.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$127.64
|
| Rate for Payer: Fidelis Essential Plan QHP |
$134.73
|
| Rate for Payer: Fidelis Medicare Advantage |
$141.82
|
| Rate for Payer: Fidelis Qualified Health Plan |
$134.73
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$141.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$141.82
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$106.36
|
| Rate for Payer: Healthfirst Commercial |
$141.82
|
| Rate for Payer: Healthfirst Essential Plan |
$319.10
|
| Rate for Payer: Healthfirst Medicare Advantage |
$134.73
|
| Rate for Payer: Healthfirst QHP |
$141.82
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$99.27
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$141.82
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$120.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$99.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$141.82
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$106.36
|
| Rate for Payer: SOMOS Essential |
$106.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$141.82
|
|
|
PR BIOPSY EXTERNAL AUDITORY CANAL
|
Professional
|
Both
|
$272.97
|
|
|
Service Code
|
HCPCS 69105
|
| Min. Negotiated Rate |
$52.75 |
| Max. Negotiated Rate |
$169.56 |
| Rate for Payer: Cash Price |
$74.48
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$75.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$67.82
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$67.82
|
| Rate for Payer: Fidelis Essential Plan QHP |
$71.59
|
| Rate for Payer: Fidelis Medicare Advantage |
$75.36
|
| Rate for Payer: Fidelis Qualified Health Plan |
$71.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$75.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$75.36
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$56.52
|
| Rate for Payer: Healthfirst Commercial |
$75.36
|
| Rate for Payer: Healthfirst Essential Plan |
$169.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$71.59
|
| Rate for Payer: Healthfirst QHP |
$75.36
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$52.75
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$75.36
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$64.06
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$52.75
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$75.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$56.52
|
| Rate for Payer: SOMOS Essential |
$56.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$75.36
|
|
|
PR BIOPSY EXTERNAL EAR
|
Professional
|
Both
|
$197.82
|
|
|
Service Code
|
HCPCS 69100
|
| Min. Negotiated Rate |
$36.31 |
| Max. Negotiated Rate |
$116.71 |
| Rate for Payer: Cash Price |
$52.74
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$51.87
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$46.68
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$46.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$49.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$51.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$49.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.87
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$51.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$38.90
|
| Rate for Payer: Healthfirst Commercial |
$51.87
|
| Rate for Payer: Healthfirst Essential Plan |
$116.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$49.28
|
| Rate for Payer: Healthfirst QHP |
$51.87
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$36.31
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$51.87
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$44.09
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$36.31
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$51.87
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$38.90
|
| Rate for Payer: SOMOS Essential |
$38.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$51.87
|
|
