|
PR BIOPSY SOFT TISSUE BACK/FLANK DEEP
|
Professional
|
Both
|
$1,674.61
|
|
|
Service Code
|
HCPCS 21925
|
| Min. Negotiated Rate |
$317.40 |
| Max. Negotiated Rate |
$1,020.22 |
| Rate for Payer: Cash Price |
$457.03
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$453.43
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$408.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$408.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$430.76
|
| Rate for Payer: Fidelis Medicare Advantage |
$453.43
|
| Rate for Payer: Fidelis Qualified Health Plan |
$430.76
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$453.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$453.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$340.07
|
| Rate for Payer: Healthfirst Commercial |
$453.43
|
| Rate for Payer: Healthfirst Essential Plan |
$1,020.22
|
| Rate for Payer: Healthfirst Medicare Advantage |
$430.76
|
| Rate for Payer: Healthfirst QHP |
$453.43
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$317.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$453.43
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$385.42
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$317.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$453.43
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$340.07
|
| Rate for Payer: SOMOS Essential |
$340.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$453.43
|
|
|
PR BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL
|
Professional
|
Both
|
$665.49
|
|
|
Service Code
|
HCPCS 21920
|
| Min. Negotiated Rate |
$126.73 |
| Max. Negotiated Rate |
$407.34 |
| Rate for Payer: Cash Price |
$181.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$181.04
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$162.94
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$162.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$171.99
|
| Rate for Payer: Fidelis Medicare Advantage |
$181.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$171.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$181.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$181.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$135.78
|
| Rate for Payer: Healthfirst Commercial |
$181.04
|
| Rate for Payer: Healthfirst Essential Plan |
$407.34
|
| Rate for Payer: Healthfirst Medicare Advantage |
$171.99
|
| Rate for Payer: Healthfirst QHP |
$181.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$126.73
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$181.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$153.88
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$126.73
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$181.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$135.78
|
| Rate for Payer: SOMOS Essential |
$135.78
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$181.04
|
|
|
PR BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP
|
Professional
|
Both
|
$1,630.30
|
|
|
Service Code
|
HCPCS 25066
|
| Min. Negotiated Rate |
$313.16 |
| Max. Negotiated Rate |
$1,006.58 |
| Rate for Payer: Cash Price |
$443.44
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$447.37
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$402.63
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$402.63
|
| Rate for Payer: Fidelis Essential Plan QHP |
$425.00
|
| Rate for Payer: Fidelis Medicare Advantage |
$447.37
|
| Rate for Payer: Fidelis Qualified Health Plan |
$425.00
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$447.37
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$447.37
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$335.53
|
| Rate for Payer: Healthfirst Commercial |
$447.37
|
| Rate for Payer: Healthfirst Essential Plan |
$1,006.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$425.00
|
| Rate for Payer: Healthfirst QHP |
$447.37
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$313.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$447.37
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$380.26
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$313.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$447.37
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$335.53
|
| Rate for Payer: SOMOS Essential |
$335.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$447.37
|
|
|
PR BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL
|
Professional
|
Both
|
$679.84
|
|
|
Service Code
|
HCPCS 25065
|
| Min. Negotiated Rate |
$128.58 |
| Max. Negotiated Rate |
$413.30 |
| Rate for Payer: Cash Price |
$185.79
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$183.69
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$165.32
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$165.32
|
| Rate for Payer: Fidelis Essential Plan QHP |
$174.51
|
| Rate for Payer: Fidelis Medicare Advantage |
$183.69
|
| Rate for Payer: Fidelis Qualified Health Plan |
$174.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$183.69
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$183.69
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$137.77
|
| Rate for Payer: Healthfirst Commercial |
$183.69
|
| Rate for Payer: Healthfirst Essential Plan |
$413.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$174.51
|
| Rate for Payer: Healthfirst QHP |
$183.69
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$128.58
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$183.69
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$156.14
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$128.58
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$183.69
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$137.77
|
| Rate for Payer: SOMOS Essential |
$137.77
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$183.69
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP
|
Professional
|
Both
|
$1,816.96
|
|
|
Service Code
|
HCPCS 27614
|
| Min. Negotiated Rate |
$339.55 |
| Max. Negotiated Rate |
$1,091.41 |
| Rate for Payer: Cash Price |
$492.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$485.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$436.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$436.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$460.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$485.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$460.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$485.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$485.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$363.80
|
| Rate for Payer: Healthfirst Commercial |
$485.07
|
| Rate for Payer: Healthfirst Essential Plan |
$1,091.41
|
| Rate for Payer: Healthfirst Medicare Advantage |
$460.82
|
| Rate for Payer: Healthfirst QHP |
$485.07
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$339.55
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$485.07
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$412.31
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$339.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$485.07
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$363.80
|
| Rate for Payer: SOMOS Essential |
$363.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$485.07
|
|
|
PR BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL
|
Professional
|
Both
|
$687.89
|
|
|
Service Code
|
HCPCS 27613
|
| Min. Negotiated Rate |
$132.21 |
| Max. Negotiated Rate |
$424.96 |
| Rate for Payer: Cash Price |
$189.78
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$188.87
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$169.98
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$169.98
|
| Rate for Payer: Fidelis Essential Plan QHP |
$179.43
|
| Rate for Payer: Fidelis Medicare Advantage |
$188.87
|
| Rate for Payer: Fidelis Qualified Health Plan |
$179.43
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$188.87
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$188.87
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$141.65
|
| Rate for Payer: Healthfirst Commercial |
$188.87
|
| Rate for Payer: Healthfirst Essential Plan |
$424.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$179.43
|
| Rate for Payer: Healthfirst QHP |
$188.87
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$132.21
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$188.87
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$160.54
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$132.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$188.87
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$141.65
|
| Rate for Payer: SOMOS Essential |
$141.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$188.87
|
|
|
PR BIOPSY SOFT TISSUE NECK/THORAX
|
Professional
|
Both
|
$671.23
|
|
|
Service Code
|
HCPCS 21550
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$406.15 |
| Rate for Payer: Cash Price |
$182.57
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$180.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$162.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$162.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$171.48
|
| Rate for Payer: Fidelis Medicare Advantage |
$180.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$171.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$180.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$180.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$135.38
|
| Rate for Payer: Healthfirst Commercial |
$180.51
|
| Rate for Payer: Healthfirst Essential Plan |
$406.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$171.48
|
| Rate for Payer: Healthfirst QHP |
$180.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$126.36
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$180.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$153.43
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$126.36
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$180.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$135.38
|
| Rate for Payer: SOMOS Essential |
$135.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$180.51
|
|
|
PR BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL
|
Professional
|
Both
|
$855.68
|
|
|
Service Code
|
HCPCS 27040
|
| Min. Negotiated Rate |
$163.46 |
| Max. Negotiated Rate |
$525.40 |
| Rate for Payer: Cash Price |
$233.17
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$233.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$210.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$210.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$221.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$233.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$221.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$233.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$233.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$175.13
|
| Rate for Payer: Healthfirst Commercial |
$233.51
|
| Rate for Payer: Healthfirst Essential Plan |
$525.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$221.83
|
| Rate for Payer: Healthfirst QHP |
$233.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$163.46
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$233.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$198.48
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$163.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$233.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$175.13
|
| Rate for Payer: SOMOS Essential |
$175.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$233.51
|
|
|
PR BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM
|
Professional
|
Both
|
$3,138.00
|
|
|
Service Code
|
HCPCS 27041
|
| Min. Negotiated Rate |
$586.79 |
| Max. Negotiated Rate |
$1,886.11 |
| Rate for Payer: Cash Price |
$845.02
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$838.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$754.44
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$754.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$796.36
|
| Rate for Payer: Fidelis Medicare Advantage |
$838.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$796.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$838.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$838.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$628.70
|
| Rate for Payer: Healthfirst Commercial |
$838.27
|
| Rate for Payer: Healthfirst Essential Plan |
$1,886.11
|
| Rate for Payer: Healthfirst Medicare Advantage |
$796.36
|
| Rate for Payer: Healthfirst QHP |
$838.27
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$586.79
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$838.27
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$712.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$586.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$838.27
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$628.70
|
| Rate for Payer: SOMOS Essential |
$628.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$838.27
|
|
|
PR BIOPSY SOFT TISSUE SHOULDER DEEP
|
Professional
|
Both
|
$1,619.14
|
|
|
Service Code
|
HCPCS 23066
|
| Min. Negotiated Rate |
$312.73 |
| Max. Negotiated Rate |
$1,005.19 |
| Rate for Payer: Cash Price |
$445.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$446.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$402.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$402.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$424.41
|
| Rate for Payer: Fidelis Medicare Advantage |
$446.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$424.41
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$446.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$446.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$335.06
|
| Rate for Payer: Healthfirst Commercial |
$446.75
|
| Rate for Payer: Healthfirst Essential Plan |
$1,005.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$424.41
|
| Rate for Payer: Healthfirst QHP |
$446.75
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$312.73
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$446.75
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$379.74
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$312.73
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$446.75
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$335.06
|
| Rate for Payer: SOMOS Essential |
$335.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$446.75
|
|
|
PR BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL
|
Professional
|
Both
|
$687.30
|
|
|
Service Code
|
HCPCS 23065
|
| Min. Negotiated Rate |
$129.84 |
| Max. Negotiated Rate |
$417.35 |
| Rate for Payer: Cash Price |
$187.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$185.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$166.94
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$166.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$176.22
|
| Rate for Payer: Fidelis Medicare Advantage |
$185.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$176.22
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$185.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$185.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$139.12
|
| Rate for Payer: Healthfirst Commercial |
$185.49
|
| Rate for Payer: Healthfirst Essential Plan |
$417.35
|
| Rate for Payer: Healthfirst Medicare Advantage |
$176.22
|
| Rate for Payer: Healthfirst QHP |
$185.49
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$129.84
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$185.49
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$157.67
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$129.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$185.49
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$139.12
|
| Rate for Payer: SOMOS Essential |
$139.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$185.49
|
|
|
PR BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP
|
Professional
|
Both
|
$1,837.43
|
|
|
Service Code
|
HCPCS 27324
|
| Min. Negotiated Rate |
$346.88 |
| Max. Negotiated Rate |
$1,114.99 |
| Rate for Payer: Cash Price |
$497.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$495.55
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$446.00
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$446.00
|
| Rate for Payer: Fidelis Essential Plan QHP |
$470.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$495.55
|
| Rate for Payer: Fidelis Qualified Health Plan |
$470.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$495.55
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$495.55
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$371.66
|
| Rate for Payer: Healthfirst Commercial |
$495.55
|
| Rate for Payer: Healthfirst Essential Plan |
$1,114.99
|
| Rate for Payer: Healthfirst Medicare Advantage |
$470.77
|
| Rate for Payer: Healthfirst QHP |
$495.55
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$346.88
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$495.55
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$421.22
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$346.88
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$495.55
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$371.66
|
| Rate for Payer: SOMOS Essential |
$371.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$495.55
|
|
|
PR BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL
|
Professional
|
Both
|
$754.29
|
|
|
Service Code
|
HCPCS 27323
|
| Min. Negotiated Rate |
$143.44 |
| Max. Negotiated Rate |
$461.07 |
| Rate for Payer: Cash Price |
$205.71
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$204.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$184.43
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$184.43
|
| Rate for Payer: Fidelis Essential Plan QHP |
$194.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$204.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$194.67
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$204.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$204.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$153.69
|
| Rate for Payer: Healthfirst Commercial |
$204.92
|
| Rate for Payer: Healthfirst Essential Plan |
$461.07
|
| Rate for Payer: Healthfirst Medicare Advantage |
$194.67
|
| Rate for Payer: Healthfirst QHP |
$204.92
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$143.44
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$204.92
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$174.18
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$143.44
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$204.92
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$153.69
|
| Rate for Payer: SOMOS Essential |
$153.69
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$204.92
|
|
|
PR BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP
|
Professional
|
Both
|
$1,873.52
|
|
|
Service Code
|
HCPCS 24066
|
| Min. Negotiated Rate |
$358.26 |
| Max. Negotiated Rate |
$1,151.55 |
| Rate for Payer: Cash Price |
$510.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$511.80
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$460.62
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$460.62
|
| Rate for Payer: Fidelis Essential Plan QHP |
$486.21
|
| Rate for Payer: Fidelis Medicare Advantage |
$511.80
|
| Rate for Payer: Fidelis Qualified Health Plan |
$486.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$511.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$511.80
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$383.85
|
| Rate for Payer: Healthfirst Commercial |
$511.80
|
| Rate for Payer: Healthfirst Essential Plan |
$1,151.55
|
| Rate for Payer: Healthfirst Medicare Advantage |
$486.21
|
| Rate for Payer: Healthfirst QHP |
$511.80
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$358.26
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$511.80
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$435.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$358.26
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$511.80
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$383.85
|
| Rate for Payer: SOMOS Essential |
$383.85
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$511.80
|
|
|
PR BIOPSY SOFT TISSUE UPPER ARM/ELBOW SUPERFICIAL
|
Professional
|
Both
|
$698.18
|
|
|
Service Code
|
HCPCS 24065
|
| Min. Negotiated Rate |
$132.38 |
| Max. Negotiated Rate |
$425.52 |
| Rate for Payer: Cash Price |
$191.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$189.12
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$170.21
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$170.21
|
| Rate for Payer: Fidelis Essential Plan QHP |
$179.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$189.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$179.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$189.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$189.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$141.84
|
| Rate for Payer: Healthfirst Commercial |
$189.12
|
| Rate for Payer: Healthfirst Essential Plan |
$425.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$179.66
|
| Rate for Payer: Healthfirst QHP |
$189.12
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$132.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$189.12
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$160.75
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$132.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$189.12
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$141.84
|
| Rate for Payer: SOMOS Essential |
$141.84
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$189.12
|
|
|
PR BIOPSY SPINAL CORD PERCUTANEOUS NEEDLE
|
Professional
|
Both
|
$1,069.88
|
|
|
Service Code
|
HCPCS 62269
|
| Min. Negotiated Rate |
$202.82 |
| Max. Negotiated Rate |
$651.94 |
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$289.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$260.77
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$260.77
|
| Rate for Payer: Fidelis Essential Plan QHP |
$275.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$289.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$275.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$289.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$289.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$217.31
|
| Rate for Payer: Healthfirst Commercial |
$289.75
|
| Rate for Payer: Healthfirst Essential Plan |
$651.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$275.26
|
| Rate for Payer: Healthfirst QHP |
$289.75
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$202.82
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$289.75
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$246.29
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$202.82
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$289.75
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$217.31
|
| Rate for Payer: SOMOS Essential |
$217.31
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$289.75
|
|
|
PR BIOPSY STOMACH LAPAROTOMY
|
Professional
|
Both
|
$3,755.40
|
|
|
Service Code
|
HCPCS 43605
|
| Min. Negotiated Rate |
$709.28 |
| Max. Negotiated Rate |
$2,279.84 |
| Rate for Payer: Cash Price |
$1,004.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,013.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$911.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$911.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$962.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,013.26
|
| Rate for Payer: Fidelis Qualified Health Plan |
$962.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,013.26
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,013.26
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$759.95
|
| Rate for Payer: Healthfirst Commercial |
$1,013.26
|
| Rate for Payer: Healthfirst Essential Plan |
$2,279.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$962.60
|
| Rate for Payer: Healthfirst QHP |
$1,013.26
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$709.28
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,013.26
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$861.27
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$709.28
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,013.26
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$759.95
|
| Rate for Payer: SOMOS Essential |
$759.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,013.26
|
|
|
PR BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE
|
Professional
|
Both
|
$882.49
|
|
|
Service Code
|
HCPCS 54505
|
| Min. Negotiated Rate |
$168.49 |
| Max. Negotiated Rate |
$541.58 |
| Rate for Payer: Cash Price |
$241.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$240.70
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$216.63
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$216.63
|
| Rate for Payer: Fidelis Essential Plan QHP |
$228.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$240.70
|
| Rate for Payer: Fidelis Qualified Health Plan |
$228.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$240.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$240.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$180.53
|
| Rate for Payer: Healthfirst Commercial |
$240.70
|
| Rate for Payer: Healthfirst Essential Plan |
$541.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$228.66
|
| Rate for Payer: Healthfirst QHP |
$240.70
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$168.49
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$240.70
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$204.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$168.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$240.70
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$180.53
|
| Rate for Payer: SOMOS Essential |
$180.53
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$240.70
|
|
|
PR BIOPSY TESTIS NEEDLE SEPARATE PROCEDURE
|
Professional
|
Both
|
$314.09
|
|
|
Service Code
|
HCPCS 54500
|
| Min. Negotiated Rate |
$59.44 |
| Max. Negotiated Rate |
$191.05 |
| Rate for Payer: Cash Price |
$85.16
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$84.91
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$76.42
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$76.42
|
| Rate for Payer: Fidelis Essential Plan QHP |
$80.66
|
| Rate for Payer: Fidelis Medicare Advantage |
$84.91
|
| Rate for Payer: Fidelis Qualified Health Plan |
$80.66
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$84.91
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$84.91
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$63.68
|
| Rate for Payer: Healthfirst Commercial |
$84.91
|
| Rate for Payer: Healthfirst Essential Plan |
$191.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$80.66
|
| Rate for Payer: Healthfirst QHP |
$84.91
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$59.44
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$84.91
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$72.17
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$59.44
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$84.91
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$63.68
|
| Rate for Payer: SOMOS Essential |
$63.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$84.91
|
|
|
PR BIOPSY THYROID PERCUTANEOUS CORE NEEDLE
|
Professional
|
Both
|
$322.25
|
|
|
Service Code
|
HCPCS 60100
|
| Min. Negotiated Rate |
$59.21 |
| Max. Negotiated Rate |
$190.33 |
| Rate for Payer: Cash Price |
$85.86
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$84.59
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$76.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$76.13
|
| Rate for Payer: Fidelis Essential Plan QHP |
$80.36
|
| Rate for Payer: Fidelis Medicare Advantage |
$84.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$80.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$84.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$84.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$63.44
|
| Rate for Payer: Healthfirst Commercial |
$84.59
|
| Rate for Payer: Healthfirst Essential Plan |
$190.33
|
| Rate for Payer: Healthfirst Medicare Advantage |
$80.36
|
| Rate for Payer: Healthfirst QHP |
$84.59
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$59.21
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$84.59
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$71.90
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$59.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$84.59
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$63.44
|
| Rate for Payer: SOMOS Essential |
$63.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$84.59
|
|
|
PR BIOPSY TONGUE ANTERIOR TWO-THIRDS
|
Professional
|
Both
|
$461.27
|
|
|
Service Code
|
HCPCS 41100
|
| Min. Negotiated Rate |
$87.14 |
| Max. Negotiated Rate |
$280.08 |
| Rate for Payer: Cash Price |
$125.46
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$124.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$112.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$112.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$118.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$124.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$118.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$124.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$124.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$93.36
|
| Rate for Payer: Healthfirst Commercial |
$124.48
|
| Rate for Payer: Healthfirst Essential Plan |
$280.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$118.26
|
| Rate for Payer: Healthfirst QHP |
$124.48
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$87.14
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$124.48
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$105.81
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$87.14
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$124.48
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$93.36
|
| Rate for Payer: SOMOS Essential |
$93.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$124.48
|
|
|
PR BIOPSY TONGUE POSTERIOR ONE-THIRD
|
Professional
|
Both
|
$471.84
|
|
|
Service Code
|
HCPCS 41105
|
| Min. Negotiated Rate |
$89.42 |
| Max. Negotiated Rate |
$287.44 |
| Rate for Payer: Cash Price |
$128.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$127.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$114.97
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$114.97
|
| Rate for Payer: Fidelis Essential Plan QHP |
$121.36
|
| Rate for Payer: Fidelis Medicare Advantage |
$127.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$121.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$127.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$127.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$95.81
|
| Rate for Payer: Healthfirst Commercial |
$127.75
|
| Rate for Payer: Healthfirst Essential Plan |
$287.44
|
| Rate for Payer: Healthfirst Medicare Advantage |
$121.36
|
| Rate for Payer: Healthfirst QHP |
$127.75
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$89.42
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$127.75
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$108.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$89.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$127.75
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$95.81
|
| Rate for Payer: SOMOS Essential |
$95.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$127.75
|
|
|
PR BIOPSY URETHRA
|
Professional
|
Both
|
$595.67
|
|
|
Service Code
|
HCPCS 53200
|
| Min. Negotiated Rate |
$113.46 |
| Max. Negotiated Rate |
$364.70 |
| Rate for Payer: Cash Price |
$162.91
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$162.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$145.88
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$145.88
|
| Rate for Payer: Fidelis Essential Plan QHP |
$153.99
|
| Rate for Payer: Fidelis Medicare Advantage |
$162.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$153.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$162.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$162.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$121.57
|
| Rate for Payer: Healthfirst Commercial |
$162.09
|
| Rate for Payer: Healthfirst Essential Plan |
$364.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$153.99
|
| Rate for Payer: Healthfirst QHP |
$162.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$113.46
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$162.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$137.78
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$113.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$162.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$121.57
|
| Rate for Payer: SOMOS Essential |
$121.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$162.09
|
|
|
PR BIOPSY VAGINAL MUCOSA EXTENSIVE
|
Professional
|
Both
|
$636.79
|
|
|
Service Code
|
HCPCS 57105
|
| Min. Negotiated Rate |
$119.29 |
| Max. Negotiated Rate |
$383.42 |
| Rate for Payer: Cash Price |
$173.91
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$170.41
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$153.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$153.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$161.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$170.41
|
| Rate for Payer: Fidelis Qualified Health Plan |
$161.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$170.41
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$170.41
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$127.81
|
| Rate for Payer: Healthfirst Commercial |
$170.41
|
| Rate for Payer: Healthfirst Essential Plan |
$383.42
|
| Rate for Payer: Healthfirst Medicare Advantage |
$161.89
|
| Rate for Payer: Healthfirst QHP |
$170.41
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$119.29
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$170.41
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$144.85
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$119.29
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$170.41
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$127.81
|
| Rate for Payer: SOMOS Essential |
$127.81
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$170.41
|
|
|
PR BIOPSY VAGINAL MUCOSA SIMPLE
|
Professional
|
Both
|
$281.33
|
|
|
Service Code
|
HCPCS 57100
|
| Min. Negotiated Rate |
$53.08 |
| Max. Negotiated Rate |
$170.62 |
| Rate for Payer: Cash Price |
$76.37
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$75.83
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$68.25
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$68.25
|
| Rate for Payer: Fidelis Essential Plan QHP |
$72.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$75.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$72.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$75.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$75.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$56.87
|
| Rate for Payer: Healthfirst Commercial |
$75.83
|
| Rate for Payer: Healthfirst Essential Plan |
$170.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$72.04
|
| Rate for Payer: Healthfirst QHP |
$75.83
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$53.08
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$75.83
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$64.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$53.08
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$75.83
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$56.87
|
| Rate for Payer: SOMOS Essential |
$56.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$75.83
|
|
