|
PR BUNDLE OF HIS RECORDING
|
Professional
|
Both
|
$507.22
|
|
|
Service Code
|
HCPCS 93600 26
|
| Min. Negotiated Rate |
$91.80 |
| Max. Negotiated Rate |
$295.06 |
| Rate for Payer: Amida Care Medicaid |
$154.23
|
| Rate for Payer: Cash Price |
$132.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$131.14
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$118.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$118.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$124.58
|
| Rate for Payer: Fidelis Medicare Advantage |
$131.14
|
| Rate for Payer: Fidelis Qualified Health Plan |
$124.58
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$131.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$131.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$98.36
|
| Rate for Payer: Healthfirst Commercial |
$131.14
|
| Rate for Payer: Healthfirst Essential Plan |
$295.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$124.58
|
| Rate for Payer: Healthfirst QHP |
$131.14
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$91.80
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$131.14
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$111.47
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$91.80
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$131.14
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$98.36
|
| Rate for Payer: SOMOS Essential |
$98.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$131.14
|
|
|
PR BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE
|
Professional
|
Both
|
$1,777.13
|
|
|
Service Code
|
HCPCS 61210
|
| Min. Negotiated Rate |
$321.28 |
| Max. Negotiated Rate |
$1,032.68 |
| Rate for Payer: Cash Price |
$463.51
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$458.97
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$413.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$413.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$436.02
|
| Rate for Payer: Fidelis Medicare Advantage |
$458.97
|
| Rate for Payer: Fidelis Qualified Health Plan |
$436.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$458.97
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$458.97
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$344.23
|
| Rate for Payer: Healthfirst Commercial |
$458.97
|
| Rate for Payer: Healthfirst Essential Plan |
$1,032.68
|
| Rate for Payer: Healthfirst Medicare Advantage |
$436.02
|
| Rate for Payer: Healthfirst QHP |
$458.97
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$321.28
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$458.97
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$390.12
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$321.28
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$458.97
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$344.23
|
| Rate for Payer: SOMOS Essential |
$344.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$458.97
|
|
|
PR BURR HOLE/TREPHINE INFRATENTORIAL UNI/BI
|
Professional
|
Both
|
$4,787.79
|
|
|
Service Code
|
HCPCS 61253
|
| Min. Negotiated Rate |
$879.16 |
| Max. Negotiated Rate |
$2,825.89 |
| Rate for Payer: Cash Price |
$1,265.88
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,255.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,130.36
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,130.36
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,193.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,255.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,193.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,255.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,255.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$941.96
|
| Rate for Payer: Healthfirst Commercial |
$1,255.95
|
| Rate for Payer: Healthfirst Essential Plan |
$2,825.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,193.15
|
| Rate for Payer: Healthfirst QHP |
$1,255.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$879.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,255.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,067.56
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$879.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,255.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$941.96
|
| Rate for Payer: SOMOS Essential |
$941.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,255.95
|
|
|
PR BURR HOLE/TREPHINE SUPRATENTORIAL W/O OTH SURG
|
Professional
|
Both
|
$4,183.17
|
|
|
Service Code
|
HCPCS 61250
|
| Min. Negotiated Rate |
$768.83 |
| Max. Negotiated Rate |
$2,471.24 |
| Rate for Payer: Cash Price |
$1,105.45
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,098.33
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$988.50
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$988.50
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,043.41
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,098.33
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,043.41
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,098.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,098.33
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$823.75
|
| Rate for Payer: Healthfirst Commercial |
$1,098.33
|
| Rate for Payer: Healthfirst Essential Plan |
$2,471.24
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,043.41
|
| Rate for Payer: Healthfirst QHP |
$1,098.33
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$768.83
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,098.33
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$933.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$768.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,098.33
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$823.75
|
| Rate for Payer: SOMOS Essential |
$823.75
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,098.33
|
|
|
PR BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION
|
Professional
|
Both
|
$6,102.78
|
|
|
Service Code
|
HCPCS 61140
|
| Min. Negotiated Rate |
$1,123.22 |
| Max. Negotiated Rate |
$3,610.35 |
| Rate for Payer: Cash Price |
$1,619.81
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,604.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,444.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,444.14
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,524.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,604.60
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,524.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,604.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,604.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,203.45
|
| Rate for Payer: Healthfirst Commercial |
$1,604.60
|
| Rate for Payer: Healthfirst Essential Plan |
$3,610.35
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,524.37
|
| Rate for Payer: Healthfirst QHP |
$1,604.60
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,123.22
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,604.60
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,363.91
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,123.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,604.60
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,203.45
|
| Rate for Payer: SOMOS Essential |
$1,203.45
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,604.60
|
|
|
PR BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST
|
Professional
|
Both
|
$6,514.55
|
|
|
Service Code
|
HCPCS 61150
|
| Min. Negotiated Rate |
$1,194.15 |
| Max. Negotiated Rate |
$3,838.34 |
| Rate for Payer: Cash Price |
$1,719.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,705.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,535.34
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,535.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,620.63
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,705.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,620.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,705.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,705.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,279.45
|
| Rate for Payer: Healthfirst Commercial |
$1,705.93
|
| Rate for Payer: Healthfirst Essential Plan |
$3,838.34
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,620.63
|
| Rate for Payer: Healthfirst QHP |
$1,705.93
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,194.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,705.93
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,450.04
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,194.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,705.93
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,279.45
|
| Rate for Payer: SOMOS Essential |
$1,279.45
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,705.93
|
|
|
PR BURR HOLE/TREPHINE W/SBSQ TAPPING ICRA ABSC/CST
|
Professional
|
Both
|
$4,787.79
|
|
|
Service Code
|
HCPCS 61151
|
| Min. Negotiated Rate |
$879.16 |
| Max. Negotiated Rate |
$2,825.89 |
| Rate for Payer: Cash Price |
$1,265.88
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,255.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,130.36
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,130.36
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,193.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,255.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,193.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,255.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,255.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$941.96
|
| Rate for Payer: Healthfirst Commercial |
$1,255.95
|
| Rate for Payer: Healthfirst Essential Plan |
$2,825.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,193.15
|
| Rate for Payer: Healthfirst QHP |
$1,255.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$879.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,255.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,067.56
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$879.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,255.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$941.96
|
| Rate for Payer: SOMOS Essential |
$941.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,255.95
|
|
|
PR BURR HOLE VENTRICULAR PUNCTURE
|
Professional
|
Both
|
$3,598.04
|
|
|
Service Code
|
HCPCS 61120
|
| Min. Negotiated Rate |
$664.07 |
| Max. Negotiated Rate |
$2,134.51 |
| Rate for Payer: Cash Price |
$955.37
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$948.67
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$853.80
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$853.80
|
| Rate for Payer: Fidelis Essential Plan QHP |
$901.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$948.67
|
| Rate for Payer: Fidelis Qualified Health Plan |
$901.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$948.67
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$948.67
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$711.50
|
| Rate for Payer: Healthfirst Commercial |
$948.67
|
| Rate for Payer: Healthfirst Essential Plan |
$2,134.51
|
| Rate for Payer: Healthfirst Medicare Advantage |
$901.24
|
| Rate for Payer: Healthfirst QHP |
$948.67
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$664.07
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$948.67
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$806.37
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$664.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$948.67
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$711.50
|
| Rate for Payer: SOMOS Essential |
$711.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$948.67
|
|
|
PR BURR HOLE W/ASPIR HEMATOMA/CYST INTRACEREBRAL
|
Professional
|
Both
|
$5,925.33
|
|
|
Service Code
|
HCPCS 61156
|
| Min. Negotiated Rate |
$1,097.03 |
| Max. Negotiated Rate |
$3,526.18 |
| Rate for Payer: Cash Price |
$1,578.43
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,567.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,410.47
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,410.47
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,488.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,567.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,488.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,567.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,567.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,175.39
|
| Rate for Payer: Healthfirst Commercial |
$1,567.19
|
| Rate for Payer: Healthfirst Essential Plan |
$3,526.18
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,488.83
|
| Rate for Payer: Healthfirst QHP |
$1,567.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,097.03
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,567.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,332.11
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,097.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,567.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,175.39
|
| Rate for Payer: SOMOS Essential |
$1,175.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,567.19
|
|
|
PR BURR HOLE W/EVAC&/DRG HEMATOMA XDRL/SDRL
|
Professional
|
Both
|
$6,135.19
|
|
|
Service Code
|
HCPCS 61154
|
| Min. Negotiated Rate |
$1,128.29 |
| Max. Negotiated Rate |
$3,626.64 |
| Rate for Payer: Cash Price |
$1,625.89
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,611.84
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,450.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,450.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,531.25
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,611.84
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,531.25
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,611.84
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,611.84
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,208.88
|
| Rate for Payer: Healthfirst Commercial |
$1,611.84
|
| Rate for Payer: Healthfirst Essential Plan |
$3,626.64
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,531.25
|
| Rate for Payer: Healthfirst QHP |
$1,611.84
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,128.29
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,611.84
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,370.06
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,128.29
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,611.84
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,208.88
|
| Rate for Payer: SOMOS Essential |
$1,208.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,611.84
|
|
|
PR BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE
|
Professional
|
Both
|
$343.56
|
|
|
Service Code
|
HCPCS 49180
|
| Min. Negotiated Rate |
$63.75 |
| Max. Negotiated Rate |
$204.91 |
| Rate for Payer: Cash Price |
$91.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$91.07
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$81.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$81.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$86.52
|
| Rate for Payer: Fidelis Medicare Advantage |
$91.07
|
| Rate for Payer: Fidelis Qualified Health Plan |
$86.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$91.07
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$91.07
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$68.30
|
| Rate for Payer: Healthfirst Commercial |
$91.07
|
| Rate for Payer: Healthfirst Essential Plan |
$204.91
|
| Rate for Payer: Healthfirst Medicare Advantage |
$86.52
|
| Rate for Payer: Healthfirst QHP |
$91.07
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$63.75
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$91.07
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$77.41
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$63.75
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$91.07
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$68.30
|
| Rate for Payer: SOMOS Essential |
$68.30
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$91.07
|
|
|
PR BX ANORECTAL WALL ANAL APPROACH
|
Professional
|
Both
|
$1,326.61
|
|
|
Service Code
|
HCPCS 45100
|
| Min. Negotiated Rate |
$250.62 |
| Max. Negotiated Rate |
$805.57 |
| Rate for Payer: Cash Price |
$360.31
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$358.03
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$322.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$322.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$340.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$358.03
|
| Rate for Payer: Fidelis Qualified Health Plan |
$340.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$358.03
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$358.03
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$268.52
|
| Rate for Payer: Healthfirst Commercial |
$358.03
|
| Rate for Payer: Healthfirst Essential Plan |
$805.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$340.13
|
| Rate for Payer: Healthfirst QHP |
$358.03
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$250.62
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$358.03
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$304.33
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$250.62
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$358.03
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$268.52
|
| Rate for Payer: SOMOS Essential |
$268.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$358.03
|
|
|
PR BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX
|
Professional
|
Both
|
$310.14
|
|
|
Service Code
|
HCPCS 19100
|
| Min. Negotiated Rate |
$56.49 |
| Max. Negotiated Rate |
$181.57 |
| Rate for Payer: Cash Price |
$82.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$80.70
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$72.63
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$72.63
|
| Rate for Payer: Fidelis Essential Plan QHP |
$76.67
|
| Rate for Payer: Fidelis Medicare Advantage |
$80.70
|
| Rate for Payer: Fidelis Qualified Health Plan |
$76.67
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$80.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$80.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$60.52
|
| Rate for Payer: Healthfirst Commercial |
$80.70
|
| Rate for Payer: Healthfirst Essential Plan |
$181.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$76.67
|
| Rate for Payer: Healthfirst QHP |
$80.70
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$56.49
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$80.70
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$68.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$56.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$80.70
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$60.52
|
| Rate for Payer: SOMOS Essential |
$60.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$80.70
|
|
|
PR BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID
|
Professional
|
Both
|
$730.49
|
|
|
Service Code
|
HCPCS 19085
|
| Min. Negotiated Rate |
$138.19 |
| Max. Negotiated Rate |
$444.19 |
| Rate for Payer: Cash Price |
$198.27
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$197.42
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$177.68
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$177.68
|
| Rate for Payer: Fidelis Essential Plan QHP |
$187.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$197.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$187.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$197.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$197.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$148.06
|
| Rate for Payer: Healthfirst Commercial |
$197.42
|
| Rate for Payer: Healthfirst Essential Plan |
$444.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$187.55
|
| Rate for Payer: Healthfirst QHP |
$197.42
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$138.19
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$197.42
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$167.81
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$138.19
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$197.42
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$148.06
|
| Rate for Payer: SOMOS Essential |
$148.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$197.42
|
|
|
PR BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID
|
Professional
|
Both
|
$676.17
|
|
|
Service Code
|
HCPCS 19081
|
| Min. Negotiated Rate |
$126.22 |
| Max. Negotiated Rate |
$405.70 |
| Rate for Payer: Cash Price |
$181.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$180.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$162.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$162.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$171.29
|
| Rate for Payer: Fidelis Medicare Advantage |
$180.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$171.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$180.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$180.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$135.23
|
| Rate for Payer: Healthfirst Commercial |
$180.31
|
| Rate for Payer: Healthfirst Essential Plan |
$405.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$171.29
|
| Rate for Payer: Healthfirst QHP |
$180.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$126.22
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$180.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$153.26
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$126.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$180.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$135.23
|
| Rate for Payer: SOMOS Essential |
$135.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$180.31
|
|
|
PR BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID
|
Professional
|
Both
|
$634.10
|
|
|
Service Code
|
HCPCS 19083
|
| Min. Negotiated Rate |
$118.44 |
| Max. Negotiated Rate |
$380.70 |
| Rate for Payer: Cash Price |
$171.98
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$169.20
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$152.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$152.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$160.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$169.20
|
| Rate for Payer: Fidelis Qualified Health Plan |
$160.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$169.20
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$169.20
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$126.90
|
| Rate for Payer: Healthfirst Commercial |
$169.20
|
| Rate for Payer: Healthfirst Essential Plan |
$380.70
|
| Rate for Payer: Healthfirst Medicare Advantage |
$160.74
|
| Rate for Payer: Healthfirst QHP |
$169.20
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$118.44
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$169.20
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$143.82
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$118.44
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$169.20
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$126.90
|
| Rate for Payer: SOMOS Essential |
$126.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$169.20
|
|
|
PR BX BREAST W/DEVICE ADDL LESION MAGNET RES GUID
|
Professional
|
Both
|
$369.36
|
|
|
Service Code
|
HCPCS 19086
|
| Min. Negotiated Rate |
$68.75 |
| Max. Negotiated Rate |
$220.97 |
| Rate for Payer: Cash Price |
$98.63
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$98.21
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$88.39
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$88.39
|
| Rate for Payer: Fidelis Essential Plan QHP |
$93.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$98.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$93.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$98.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$98.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$73.66
|
| Rate for Payer: Healthfirst Commercial |
$98.21
|
| Rate for Payer: Healthfirst Essential Plan |
$220.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$93.30
|
| Rate for Payer: Healthfirst QHP |
$98.21
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$68.75
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$98.21
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$83.48
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$68.75
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$98.21
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$73.66
|
| Rate for Payer: SOMOS Essential |
$73.66
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$98.21
|
|
|
PR BX BREAST W/DEVICE ADDL LESION STEREOTACT GUID
|
Professional
|
Both
|
$342.16
|
|
|
Service Code
|
HCPCS 19082
|
| Min. Negotiated Rate |
$63.01 |
| Max. Negotiated Rate |
$202.54 |
| Rate for Payer: Cash Price |
$90.97
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$90.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$81.02
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$81.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$85.52
|
| Rate for Payer: Fidelis Medicare Advantage |
$90.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$85.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$90.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$90.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$67.52
|
| Rate for Payer: Healthfirst Commercial |
$90.02
|
| Rate for Payer: Healthfirst Essential Plan |
$202.54
|
| Rate for Payer: Healthfirst Medicare Advantage |
$85.52
|
| Rate for Payer: Healthfirst QHP |
$90.02
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$63.01
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$90.02
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$76.52
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$63.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$90.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$67.52
|
| Rate for Payer: SOMOS Essential |
$67.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$90.02
|
|
|
PR BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID
|
Professional
|
Both
|
$322.60
|
|
|
Service Code
|
HCPCS 19084
|
| Min. Negotiated Rate |
$59.79 |
| Max. Negotiated Rate |
$192.17 |
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$85.41
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$76.87
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$76.87
|
| Rate for Payer: Fidelis Essential Plan QHP |
$81.14
|
| Rate for Payer: Fidelis Medicare Advantage |
$85.41
|
| Rate for Payer: Fidelis Qualified Health Plan |
$81.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$85.41
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$85.41
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$64.06
|
| Rate for Payer: Healthfirst Commercial |
$85.41
|
| Rate for Payer: Healthfirst Essential Plan |
$192.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$81.14
|
| Rate for Payer: Healthfirst QHP |
$85.41
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$59.79
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$85.41
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$72.60
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$59.79
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$85.41
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$64.06
|
| Rate for Payer: SOMOS Essential |
$64.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$85.41
|
|
|
PR BX/EXC LYMPH NODE NEEDLE SUPERFICIAL
|
Professional
|
Both
|
$357.77
|
|
|
Service Code
|
HCPCS 38505
|
| Min. Negotiated Rate |
$67.00 |
| Max. Negotiated Rate |
$215.37 |
| Rate for Payer: Cash Price |
$96.11
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$95.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$86.15
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$86.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$90.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$95.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$90.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$95.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$95.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$71.79
|
| Rate for Payer: Healthfirst Commercial |
$95.72
|
| Rate for Payer: Healthfirst Essential Plan |
$215.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$90.93
|
| Rate for Payer: Healthfirst QHP |
$95.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$67.00
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$95.72
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$81.36
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$67.00
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$95.72
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$71.79
|
| Rate for Payer: SOMOS Essential |
$71.79
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$95.72
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE
|
Professional
|
Both
|
$1,985.31
|
|
|
Service Code
|
HCPCS 38525
|
| Min. Negotiated Rate |
$370.85 |
| Max. Negotiated Rate |
$1,192.03 |
| Rate for Payer: Cash Price |
$533.23
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$529.79
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$476.81
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$476.81
|
| Rate for Payer: Fidelis Essential Plan QHP |
$503.30
|
| Rate for Payer: Fidelis Medicare Advantage |
$529.79
|
| Rate for Payer: Fidelis Qualified Health Plan |
$503.30
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$529.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$529.79
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$397.34
|
| Rate for Payer: Healthfirst Commercial |
$529.79
|
| Rate for Payer: Healthfirst Essential Plan |
$1,192.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$503.30
|
| Rate for Payer: Healthfirst QHP |
$529.79
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$370.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$529.79
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$450.32
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$370.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$529.79
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$397.34
|
| Rate for Payer: SOMOS Essential |
$397.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$529.79
|
|
|
PR BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE
|
Professional
|
Both
|
$1,844.15
|
|
|
Service Code
|
HCPCS 38510
|
| Min. Negotiated Rate |
$343.72 |
| Max. Negotiated Rate |
$1,104.82 |
| Rate for Payer: Cash Price |
$494.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$491.03
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$441.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$441.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$466.48
|
| Rate for Payer: Fidelis Medicare Advantage |
$491.03
|
| Rate for Payer: Fidelis Qualified Health Plan |
$466.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$491.03
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$491.03
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$368.27
|
| Rate for Payer: Healthfirst Commercial |
$491.03
|
| Rate for Payer: Healthfirst Essential Plan |
$1,104.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$466.48
|
| Rate for Payer: Healthfirst QHP |
$491.03
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$343.72
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$491.03
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$417.38
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$343.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$491.03
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$368.27
|
| Rate for Payer: SOMOS Essential |
$368.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$491.03
|
|
|
PR BX/EXC LYMPH NODE OPEN INT MAMMARY NODE
|
Professional
|
Both
|
$2,493.12
|
|
|
Service Code
|
HCPCS 38530
|
| Min. Negotiated Rate |
$472.85 |
| Max. Negotiated Rate |
$1,519.88 |
| Rate for Payer: Cash Price |
$674.37
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$675.50
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$607.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$607.95
|
| Rate for Payer: Fidelis Essential Plan QHP |
$641.73
|
| Rate for Payer: Fidelis Medicare Advantage |
$675.50
|
| Rate for Payer: Fidelis Qualified Health Plan |
$641.73
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$675.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$675.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$506.62
|
| Rate for Payer: Healthfirst Commercial |
$675.50
|
| Rate for Payer: Healthfirst Essential Plan |
$1,519.88
|
| Rate for Payer: Healthfirst Medicare Advantage |
$641.73
|
| Rate for Payer: Healthfirst QHP |
$675.50
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$472.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$675.50
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$574.17
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$472.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$675.50
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$506.62
|
| Rate for Payer: SOMOS Essential |
$506.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$675.50
|
|
|
PR BX/EXC LYMPH NODE OPEN SUPERFICIAL
|
Professional
|
Both
|
$1,145.13
|
|
|
Service Code
|
HCPCS 38500
|
| Min. Negotiated Rate |
$212.61 |
| Max. Negotiated Rate |
$683.39 |
| Rate for Payer: Cash Price |
$306.76
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$303.73
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$273.36
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$273.36
|
| Rate for Payer: Fidelis Essential Plan QHP |
$288.54
|
| Rate for Payer: Fidelis Medicare Advantage |
$303.73
|
| Rate for Payer: Fidelis Qualified Health Plan |
$288.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$303.73
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$303.73
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$227.80
|
| Rate for Payer: Healthfirst Commercial |
$303.73
|
| Rate for Payer: Healthfirst Essential Plan |
$683.39
|
| Rate for Payer: Healthfirst Medicare Advantage |
$288.54
|
| Rate for Payer: Healthfirst QHP |
$303.73
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$212.61
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$303.73
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$258.17
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$212.61
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$303.73
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$227.80
|
| Rate for Payer: SOMOS Essential |
$227.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$303.73
|
|
|
PR BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD
|
Professional
|
Both
|
$2,075.05
|
|
|
Service Code
|
HCPCS 38520
|
| Min. Negotiated Rate |
$389.36 |
| Max. Negotiated Rate |
$1,251.52 |
| Rate for Payer: Cash Price |
$557.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$556.23
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$500.61
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$500.61
|
| Rate for Payer: Fidelis Essential Plan QHP |
$528.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$556.23
|
| Rate for Payer: Fidelis Qualified Health Plan |
$528.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$556.23
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$556.23
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$417.17
|
| Rate for Payer: Healthfirst Commercial |
$556.23
|
| Rate for Payer: Healthfirst Essential Plan |
$1,251.52
|
| Rate for Payer: Healthfirst Medicare Advantage |
$528.42
|
| Rate for Payer: Healthfirst QHP |
$556.23
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$389.36
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$556.23
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$472.80
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$389.36
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$556.23
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$417.17
|
| Rate for Payer: SOMOS Essential |
$417.17
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$556.23
|
|
