|
PR CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I
|
Professional
|
Both
|
$2,906.05
|
|
|
Service Code
|
HCPCS 93454 TC
|
| Min. Negotiated Rate |
$422.34 |
| Max. Negotiated Rate |
$1,650.96 |
| Rate for Payer: Amida Care Medicaid |
$422.34
|
| Rate for Payer: Cash Price |
$778.38
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$733.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$660.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$660.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$697.07
|
| Rate for Payer: Fidelis Medicare Advantage |
$733.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$697.07
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$733.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$733.76
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$550.32
|
| Rate for Payer: Healthfirst Commercial |
$733.76
|
| Rate for Payer: Healthfirst Essential Plan |
$1,650.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$697.07
|
| Rate for Payer: Healthfirst QHP |
$733.76
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$513.63
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$733.76
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$623.70
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$513.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$733.76
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$550.32
|
| Rate for Payer: SOMOS Essential |
$550.32
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$733.76
|
|
|
PR CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I
|
Professional
|
Both
|
$3,427.87
|
|
|
Service Code
|
HCPCS 93459 TC
|
| Min. Negotiated Rate |
$562.40 |
| Max. Negotiated Rate |
$1,951.92 |
| Rate for Payer: Amida Care Medicaid |
$562.40
|
| Rate for Payer: Cash Price |
$919.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$867.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$780.77
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$780.77
|
| Rate for Payer: Fidelis Essential Plan QHP |
$824.14
|
| Rate for Payer: Fidelis Medicare Advantage |
$867.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$824.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$867.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$867.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$650.64
|
| Rate for Payer: Healthfirst Commercial |
$867.52
|
| Rate for Payer: Healthfirst Essential Plan |
$1,951.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$824.14
|
| Rate for Payer: Healthfirst QHP |
$867.52
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$607.26
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$867.52
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$737.39
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$607.26
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$867.52
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$650.64
|
| Rate for Payer: SOMOS Essential |
$650.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$867.52
|
|
|
PR CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I
|
Professional
|
Both
|
$1,428.84
|
|
|
Service Code
|
HCPCS 93459 26
|
| Min. Negotiated Rate |
$263.96 |
| Max. Negotiated Rate |
$848.45 |
| Rate for Payer: Amida Care Medicaid |
$562.40
|
| Rate for Payer: Cash Price |
$382.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$377.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$339.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$339.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$358.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$377.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$358.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$377.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$377.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$282.82
|
| Rate for Payer: Healthfirst Commercial |
$377.09
|
| Rate for Payer: Healthfirst Essential Plan |
$848.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$358.24
|
| Rate for Payer: Healthfirst QHP |
$377.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$263.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$377.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$320.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$263.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$377.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$282.82
|
| Rate for Payer: SOMOS Essential |
$282.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$377.09
|
|
|
PR CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I
|
Professional
|
Both
|
$4,856.71
|
|
|
Service Code
|
HCPCS 93459
|
| Min. Negotiated Rate |
$562.40 |
| Max. Negotiated Rate |
$2,800.37 |
| Rate for Payer: Amida Care Medicaid |
$562.40
|
| Rate for Payer: Cash Price |
$1,301.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,244.61
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,120.15
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,120.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,182.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,244.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,182.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,244.61
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,244.61
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$933.46
|
| Rate for Payer: Healthfirst Commercial |
$1,244.61
|
| Rate for Payer: Healthfirst Essential Plan |
$2,800.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,182.38
|
| Rate for Payer: Healthfirst QHP |
$1,244.61
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$871.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,244.61
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,057.92
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$871.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,244.61
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$933.46
|
| Rate for Payer: SOMOS Essential |
$933.46
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,244.61
|
|
|
PR CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I
|
Professional
|
Both
|
$1,259.23
|
|
|
Service Code
|
HCPCS 93458 26
|
| Min. Negotiated Rate |
$232.75 |
| Max. Negotiated Rate |
$748.12 |
| Rate for Payer: Amida Care Medicaid |
$509.25
|
| Rate for Payer: Cash Price |
$337.68
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$332.50
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$299.25
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$299.25
|
| Rate for Payer: Fidelis Essential Plan QHP |
$315.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$332.50
|
| Rate for Payer: Fidelis Qualified Health Plan |
$315.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$332.50
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$332.50
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$249.38
|
| Rate for Payer: Healthfirst Commercial |
$332.50
|
| Rate for Payer: Healthfirst Essential Plan |
$748.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$315.88
|
| Rate for Payer: Healthfirst QHP |
$332.50
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$232.75
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$332.50
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$282.62
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$232.75
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$332.50
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$249.38
|
| Rate for Payer: SOMOS Essential |
$249.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$332.50
|
|
|
PR CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I
|
Professional
|
Both
|
$4,513.15
|
|
|
Service Code
|
HCPCS 93458
|
| Min. Negotiated Rate |
$509.25 |
| Max. Negotiated Rate |
$2,601.36 |
| Rate for Payer: Amida Care Medicaid |
$509.25
|
| Rate for Payer: Cash Price |
$1,209.97
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,156.16
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,040.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,040.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,098.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,156.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,098.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,156.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,156.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$867.12
|
| Rate for Payer: Healthfirst Commercial |
$1,156.16
|
| Rate for Payer: Healthfirst Essential Plan |
$2,601.36
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,098.35
|
| Rate for Payer: Healthfirst QHP |
$1,156.16
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$809.31
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,156.16
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$982.74
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$809.31
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,156.16
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$867.12
|
| Rate for Payer: SOMOS Essential |
$867.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,156.16
|
|
|
PR CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I
|
Professional
|
Both
|
$3,253.95
|
|
|
Service Code
|
HCPCS 93458 TC
|
| Min. Negotiated Rate |
$509.25 |
| Max. Negotiated Rate |
$1,853.23 |
| Rate for Payer: Amida Care Medicaid |
$509.25
|
| Rate for Payer: Cash Price |
$872.29
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$823.66
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$741.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$741.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$782.48
|
| Rate for Payer: Fidelis Medicare Advantage |
$823.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$782.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$823.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$823.66
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$617.75
|
| Rate for Payer: Healthfirst Commercial |
$823.66
|
| Rate for Payer: Healthfirst Essential Plan |
$1,853.23
|
| Rate for Payer: Healthfirst Medicare Advantage |
$782.48
|
| Rate for Payer: Healthfirst QHP |
$823.66
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$576.56
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$823.66
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$700.11
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$576.56
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$823.66
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$617.75
|
| Rate for Payer: SOMOS Essential |
$617.75
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$823.66
|
|
|
PR CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I
|
Professional
|
Both
|
$4,374.55
|
|
|
Service Code
|
HCPCS 93455
|
| Min. Negotiated Rate |
$492.60 |
| Max. Negotiated Rate |
$2,521.46 |
| Rate for Payer: Amida Care Medicaid |
$492.60
|
| Rate for Payer: Cash Price |
$1,171.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,120.65
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,008.59
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,008.59
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,064.62
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,120.65
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,064.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,120.65
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,120.65
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$840.49
|
| Rate for Payer: Healthfirst Commercial |
$1,120.65
|
| Rate for Payer: Healthfirst Essential Plan |
$2,521.46
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,064.62
|
| Rate for Payer: Healthfirst QHP |
$1,120.65
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$784.46
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,120.65
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$952.55
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$784.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,120.65
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$840.49
|
| Rate for Payer: SOMOS Essential |
$840.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,120.65
|
|
|
PR CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I
|
Professional
|
Both
|
$3,184.93
|
|
|
Service Code
|
HCPCS 93455 TC
|
| Min. Negotiated Rate |
$492.60 |
| Max. Negotiated Rate |
$1,811.65 |
| Rate for Payer: Amida Care Medicaid |
$492.60
|
| Rate for Payer: Cash Price |
$853.04
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$805.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$724.66
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$724.66
|
| Rate for Payer: Fidelis Essential Plan QHP |
$764.92
|
| Rate for Payer: Fidelis Medicare Advantage |
$805.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$764.92
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$805.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$805.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$603.88
|
| Rate for Payer: Healthfirst Commercial |
$805.18
|
| Rate for Payer: Healthfirst Essential Plan |
$1,811.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$764.92
|
| Rate for Payer: Healthfirst QHP |
$805.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$563.63
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$805.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$684.40
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$563.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$805.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$603.88
|
| Rate for Payer: SOMOS Essential |
$603.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$805.18
|
|
|
PR CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I
|
Professional
|
Both
|
$1,189.58
|
|
|
Service Code
|
HCPCS 93455 26
|
| Min. Negotiated Rate |
$220.83 |
| Max. Negotiated Rate |
$709.81 |
| Rate for Payer: Amida Care Medicaid |
$492.60
|
| Rate for Payer: Cash Price |
$318.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$315.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$283.92
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$283.92
|
| Rate for Payer: Fidelis Essential Plan QHP |
$299.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$315.47
|
| Rate for Payer: Fidelis Qualified Health Plan |
$299.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$315.47
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$315.47
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$236.60
|
| Rate for Payer: Healthfirst Commercial |
$315.47
|
| Rate for Payer: Healthfirst Essential Plan |
$709.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$299.70
|
| Rate for Payer: Healthfirst QHP |
$315.47
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$220.83
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$315.47
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$268.15
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$220.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$315.47
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$236.60
|
| Rate for Payer: SOMOS Essential |
$236.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$315.47
|
|
|
PR CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I
|
Professional
|
Both
|
$3,830.37
|
|
|
Service Code
|
HCPCS 93457 TC
|
| Min. Negotiated Rate |
$598.55 |
| Max. Negotiated Rate |
$2,177.24 |
| Rate for Payer: Amida Care Medicaid |
$598.55
|
| Rate for Payer: Cash Price |
$1,026.16
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$967.66
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$870.89
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$870.89
|
| Rate for Payer: Fidelis Essential Plan QHP |
$919.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$967.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$919.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$967.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$967.66
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$725.75
|
| Rate for Payer: Healthfirst Commercial |
$967.66
|
| Rate for Payer: Healthfirst Essential Plan |
$2,177.24
|
| Rate for Payer: Healthfirst Medicare Advantage |
$919.28
|
| Rate for Payer: Healthfirst QHP |
$967.66
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$677.36
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$967.66
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$822.51
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$677.36
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$967.66
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$725.75
|
| Rate for Payer: SOMOS Essential |
$725.75
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$967.66
|
|
|
PR CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I
|
Professional
|
Both
|
$5,322.28
|
|
|
Service Code
|
HCPCS 93457
|
| Min. Negotiated Rate |
$598.55 |
| Max. Negotiated Rate |
$3,068.39 |
| Rate for Payer: Amida Care Medicaid |
$598.55
|
| Rate for Payer: Cash Price |
$1,425.91
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,363.73
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,227.36
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,227.36
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,295.54
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,363.73
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,295.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,363.73
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,363.73
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,022.80
|
| Rate for Payer: Healthfirst Commercial |
$1,363.73
|
| Rate for Payer: Healthfirst Essential Plan |
$3,068.39
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,295.54
|
| Rate for Payer: Healthfirst QHP |
$1,363.73
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$954.61
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,363.73
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,159.17
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$954.61
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,363.73
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,022.80
|
| Rate for Payer: SOMOS Essential |
$1,022.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,363.73
|
|
|
PR CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I
|
Professional
|
Both
|
$1,491.91
|
|
|
Service Code
|
HCPCS 93457 26
|
| Min. Negotiated Rate |
$277.24 |
| Max. Negotiated Rate |
$891.13 |
| Rate for Payer: Amida Care Medicaid |
$598.55
|
| Rate for Payer: Cash Price |
$399.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$396.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$356.45
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$356.45
|
| Rate for Payer: Fidelis Essential Plan QHP |
$376.26
|
| Rate for Payer: Fidelis Medicare Advantage |
$396.06
|
| Rate for Payer: Fidelis Qualified Health Plan |
$376.26
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$396.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$396.06
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$297.05
|
| Rate for Payer: Healthfirst Commercial |
$396.06
|
| Rate for Payer: Healthfirst Essential Plan |
$891.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$376.26
|
| Rate for Payer: Healthfirst QHP |
$396.06
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$277.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$396.06
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$336.65
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$277.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$396.06
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$297.05
|
| Rate for Payer: SOMOS Essential |
$297.05
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$396.06
|
|
|
PR CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I
|
Professional
|
Both
|
$3,555.83
|
|
|
Service Code
|
HCPCS 93456 TC
|
| Min. Negotiated Rate |
$528.28 |
| Max. Negotiated Rate |
$2,018.65 |
| Rate for Payer: Amida Care Medicaid |
$528.28
|
| Rate for Payer: Cash Price |
$952.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$897.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$807.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$807.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$852.32
|
| Rate for Payer: Fidelis Medicare Advantage |
$897.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$852.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$897.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$897.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$672.88
|
| Rate for Payer: Healthfirst Commercial |
$897.18
|
| Rate for Payer: Healthfirst Essential Plan |
$2,018.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$852.32
|
| Rate for Payer: Healthfirst QHP |
$897.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$628.03
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$897.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$762.60
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$628.03
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$897.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$672.88
|
| Rate for Payer: SOMOS Essential |
$672.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$897.18
|
|
|
PR CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I
|
Professional
|
Both
|
$4,884.95
|
|
|
Service Code
|
HCPCS 93456
|
| Min. Negotiated Rate |
$528.28 |
| Max. Negotiated Rate |
$2,811.13 |
| Rate for Payer: Amida Care Medicaid |
$528.28
|
| Rate for Payer: Cash Price |
$1,308.67
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,249.39
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,124.45
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,124.45
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,186.92
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,249.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,186.92
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,249.39
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,249.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$937.04
|
| Rate for Payer: Healthfirst Commercial |
$1,249.39
|
| Rate for Payer: Healthfirst Essential Plan |
$2,811.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,186.92
|
| Rate for Payer: Healthfirst QHP |
$1,249.39
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$874.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,249.39
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,061.98
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$874.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,249.39
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$937.04
|
| Rate for Payer: SOMOS Essential |
$937.04
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,249.39
|
|
|
PR CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I
|
Professional
|
Both
|
$1,329.16
|
|
|
Service Code
|
HCPCS 93456 26
|
| Min. Negotiated Rate |
$246.55 |
| Max. Negotiated Rate |
$792.47 |
| Rate for Payer: Amida Care Medicaid |
$528.28
|
| Rate for Payer: Cash Price |
$356.61
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$352.21
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$316.99
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$316.99
|
| Rate for Payer: Fidelis Essential Plan QHP |
$334.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$352.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$334.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$352.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$352.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$264.16
|
| Rate for Payer: Healthfirst Commercial |
$352.21
|
| Rate for Payer: Healthfirst Essential Plan |
$792.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$334.60
|
| Rate for Payer: Healthfirst QHP |
$352.21
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$246.55
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$352.21
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$299.38
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$246.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$352.21
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$264.16
|
| Rate for Payer: SOMOS Essential |
$264.16
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$352.21
|
|
|
PR CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI
|
Professional
|
Both
|
$247.70
|
|
|
Service Code
|
HCPCS 58340
|
| Min. Negotiated Rate |
$47.27 |
| Max. Negotiated Rate |
$151.94 |
| Rate for Payer: Cash Price |
$67.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$67.53
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$60.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$60.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$64.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$67.53
|
| Rate for Payer: Fidelis Qualified Health Plan |
$64.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$67.53
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$67.53
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$50.65
|
| Rate for Payer: Healthfirst Commercial |
$67.53
|
| Rate for Payer: Healthfirst Essential Plan |
$151.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$64.15
|
| Rate for Payer: Healthfirst QHP |
$67.53
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$47.27
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$67.53
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$57.40
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$47.27
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$67.53
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$50.65
|
| Rate for Payer: SOMOS Essential |
$50.65
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$67.53
|
|
|
PR CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT
|
Professional
|
Both
|
$640.99
|
|
|
Service Code
|
HCPCS 57511
|
| Min. Negotiated Rate |
$120.26 |
| Max. Negotiated Rate |
$386.55 |
| Rate for Payer: Cash Price |
$174.70
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$171.80
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$154.62
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$154.62
|
| Rate for Payer: Fidelis Essential Plan QHP |
$163.21
|
| Rate for Payer: Fidelis Medicare Advantage |
$171.80
|
| Rate for Payer: Fidelis Qualified Health Plan |
$163.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$171.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$171.80
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$128.85
|
| Rate for Payer: Healthfirst Commercial |
$171.80
|
| Rate for Payer: Healthfirst Essential Plan |
$386.55
|
| Rate for Payer: Healthfirst Medicare Advantage |
$163.21
|
| Rate for Payer: Healthfirst QHP |
$171.80
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$120.26
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$171.80
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$146.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$120.26
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$171.80
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$128.85
|
| Rate for Payer: SOMOS Essential |
$128.85
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$171.80
|
|
|
PR CAUTERY CERVIX ELECTRO/THERMAL
|
Professional
|
Both
|
$486.82
|
|
|
Service Code
|
HCPCS 57510
|
| Min. Negotiated Rate |
$91.41 |
| Max. Negotiated Rate |
$293.81 |
| Rate for Payer: Cash Price |
$133.04
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$130.58
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$117.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$117.52
|
| Rate for Payer: Fidelis Essential Plan QHP |
$124.05
|
| Rate for Payer: Fidelis Medicare Advantage |
$130.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$124.05
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$130.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$130.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$97.94
|
| Rate for Payer: Healthfirst Commercial |
$130.58
|
| Rate for Payer: Healthfirst Essential Plan |
$293.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$124.05
|
| Rate for Payer: Healthfirst QHP |
$130.58
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$91.41
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$130.58
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$110.99
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$91.41
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$130.58
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$97.94
|
| Rate for Payer: SOMOS Essential |
$97.94
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$130.58
|
|
|
PR CAUTERY CERVIX LASER ABLATION
|
Professional
|
Both
|
$639.56
|
|
|
Service Code
|
HCPCS 57513
|
| Min. Negotiated Rate |
$119.72 |
| Max. Negotiated Rate |
$384.82 |
| Rate for Payer: Cash Price |
$173.92
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$171.03
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$153.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$153.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$162.48
|
| Rate for Payer: Fidelis Medicare Advantage |
$171.03
|
| Rate for Payer: Fidelis Qualified Health Plan |
$162.48
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$171.03
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$171.03
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$128.27
|
| Rate for Payer: Healthfirst Commercial |
$171.03
|
| Rate for Payer: Healthfirst Essential Plan |
$384.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$162.48
|
| Rate for Payer: Healthfirst QHP |
$171.03
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$119.72
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$171.03
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$145.38
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$119.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$171.03
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$128.27
|
| Rate for Payer: SOMOS Essential |
$128.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$171.03
|
|
|
PR CCIIV4 VACCINE PRESERVATIVE FREE 0.5 ML IM USE
|
Professional
|
Both
|
$75.42
|
|
|
Service Code
|
HCPCS 90674
|
| Rate for Payer: Cash Price |
$34.17
|
|
|
PR CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT
|
Professional
|
Both
|
$132.51
|
|
|
Service Code
|
HCPCS 92548 26
|
| Min. Negotiated Rate |
$25.17 |
| Max. Negotiated Rate |
$80.91 |
| Rate for Payer: Cash Price |
$36.40
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$35.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$32.36
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$32.36
|
| Rate for Payer: Fidelis Essential Plan QHP |
$34.16
|
| Rate for Payer: Fidelis Medicare Advantage |
$35.96
|
| Rate for Payer: Fidelis Qualified Health Plan |
$34.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$35.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$35.96
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26.97
|
| Rate for Payer: Healthfirst Commercial |
$35.96
|
| Rate for Payer: Healthfirst Essential Plan |
$80.91
|
| Rate for Payer: Healthfirst Medicare Advantage |
$34.16
|
| Rate for Payer: Healthfirst QHP |
$35.96
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$25.17
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$35.96
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$30.57
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$25.17
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$35.96
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26.97
|
| Rate for Payer: SOMOS Essential |
$26.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$35.96
|
|
|
PR CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT
|
Professional
|
Both
|
$194.18
|
|
|
Service Code
|
HCPCS 92548
|
| Min. Negotiated Rate |
$36.48 |
| Max. Negotiated Rate |
$117.25 |
| Rate for Payer: Cash Price |
$53.14
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$52.11
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$46.90
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$46.90
|
| Rate for Payer: Fidelis Essential Plan QHP |
$49.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$52.11
|
| Rate for Payer: Fidelis Qualified Health Plan |
$49.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$52.11
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$52.11
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$39.08
|
| Rate for Payer: Healthfirst Commercial |
$52.11
|
| Rate for Payer: Healthfirst Essential Plan |
$117.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$49.50
|
| Rate for Payer: Healthfirst QHP |
$52.11
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$36.48
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$52.11
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$44.29
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$36.48
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$52.11
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$39.08
|
| Rate for Payer: SOMOS Essential |
$39.08
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$52.11
|
|
|
PR CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT
|
Professional
|
Both
|
$61.67
|
|
|
Service Code
|
HCPCS 92548 TC
|
| Min. Negotiated Rate |
$11.30 |
| Max. Negotiated Rate |
$36.31 |
| Rate for Payer: Cash Price |
$16.74
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$16.14
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$14.53
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$14.53
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.33
|
| Rate for Payer: Fidelis Medicare Advantage |
$16.14
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.33
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.11
|
| Rate for Payer: Healthfirst Commercial |
$16.14
|
| Rate for Payer: Healthfirst Essential Plan |
$36.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.33
|
| Rate for Payer: Healthfirst QHP |
$16.14
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$11.30
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$16.14
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$13.72
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$11.30
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$16.14
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$12.11
|
| Rate for Payer: SOMOS Essential |
$12.11
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16.14
|
|
|
PR CDP-SOT 6 CONDITIONS W/I&R W/MCT & ADT
|
Professional
|
Both
|
$88.97
|
|
|
Service Code
|
HCPCS 92549 TC
|
| Min. Negotiated Rate |
$16.74 |
| Max. Negotiated Rate |
$53.80 |
| Rate for Payer: Cash Price |
$24.20
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$23.91
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$21.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$21.52
|
| Rate for Payer: Fidelis Essential Plan QHP |
$22.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$23.91
|
| Rate for Payer: Fidelis Qualified Health Plan |
$22.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$23.91
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$23.91
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$17.93
|
| Rate for Payer: Healthfirst Commercial |
$23.91
|
| Rate for Payer: Healthfirst Essential Plan |
$53.80
|
| Rate for Payer: Healthfirst Medicare Advantage |
$22.71
|
| Rate for Payer: Healthfirst QHP |
$23.91
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$16.74
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$23.91
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$20.32
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$16.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$23.91
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$17.93
|
| Rate for Payer: SOMOS Essential |
$17.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$23.91
|
|
