|
PR COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR
|
Professional
|
Both
|
$10,110.94
|
|
|
Service Code
|
HCPCS 44158
|
| Min. Negotiated Rate |
$1,864.35 |
| Max. Negotiated Rate |
$5,992.54 |
| Rate for Payer: Cash Price |
$2,690.32
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,663.35
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,397.01
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,397.01
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,530.18
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,663.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,530.18
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,663.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,663.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,997.51
|
| Rate for Payer: Healthfirst Commercial |
$2,663.35
|
| Rate for Payer: Healthfirst Essential Plan |
$5,992.54
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,530.18
|
| Rate for Payer: Healthfirst QHP |
$2,663.35
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,864.35
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,663.35
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,263.85
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,864.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,663.35
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,997.51
|
| Rate for Payer: SOMOS Essential |
$1,997.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,663.35
|
|
|
PR COLECTOMY PARTIAL W/ANASTOMOSIS
|
Professional
|
Both
|
$6,004.18
|
|
|
Service Code
|
HCPCS 44140
|
| Min. Negotiated Rate |
$1,112.96 |
| Max. Negotiated Rate |
$3,577.36 |
| Rate for Payer: Cash Price |
$1,603.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,589.94
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,430.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,430.95
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,510.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,589.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,510.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,589.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,589.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,192.45
|
| Rate for Payer: Healthfirst Commercial |
$1,589.94
|
| Rate for Payer: Healthfirst Essential Plan |
$3,577.36
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,510.44
|
| Rate for Payer: Healthfirst QHP |
$1,589.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,112.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,589.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,351.45
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,112.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,589.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,192.45
|
| Rate for Payer: SOMOS Essential |
$1,192.45
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,589.94
|
|
|
PR COLECTOMY PRTL ABDOMINAL & TRANSANAL APPROACH
|
Professional
|
Both
|
$8,586.52
|
|
|
Service Code
|
HCPCS 44147
|
| Min. Negotiated Rate |
$1,597.02 |
| Max. Negotiated Rate |
$5,133.26 |
| Rate for Payer: Cash Price |
$2,296.82
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,281.45
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,053.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,053.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,167.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,281.45
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,167.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,281.45
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,281.45
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,711.09
|
| Rate for Payer: Healthfirst Commercial |
$2,281.45
|
| Rate for Payer: Healthfirst Essential Plan |
$5,133.26
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,167.38
|
| Rate for Payer: Healthfirst QHP |
$2,281.45
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,597.02
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,281.45
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,939.23
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,597.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,281.45
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,711.09
|
| Rate for Payer: SOMOS Essential |
$1,711.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,281.45
|
|
|
PR COLECTOMY PRTL W/COLOPROCTOSTOMY
|
Professional
|
Both
|
$7,294.18
|
|
|
Service Code
|
HCPCS 44145
|
| Min. Negotiated Rate |
$1,351.48 |
| Max. Negotiated Rate |
$4,344.05 |
| Rate for Payer: Cash Price |
$1,950.38
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,930.69
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,737.62
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,737.62
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,834.16
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,930.69
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,834.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,930.69
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,930.69
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,448.02
|
| Rate for Payer: Healthfirst Commercial |
$1,930.69
|
| Rate for Payer: Healthfirst Essential Plan |
$4,344.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,834.16
|
| Rate for Payer: Healthfirst QHP |
$1,930.69
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,351.48
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,930.69
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,641.09
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,351.48
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,930.69
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,448.02
|
| Rate for Payer: SOMOS Essential |
$1,448.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,930.69
|
|
|
PR COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY
|
Professional
|
Both
|
$9,264.54
|
|
|
Service Code
|
HCPCS 44146
|
| Min. Negotiated Rate |
$1,721.96 |
| Max. Negotiated Rate |
$5,534.89 |
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,459.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,213.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,213.95
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,336.95
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,459.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,336.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,459.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,459.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,844.96
|
| Rate for Payer: Healthfirst Commercial |
$2,459.95
|
| Rate for Payer: Healthfirst Essential Plan |
$5,534.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,336.95
|
| Rate for Payer: Healthfirst QHP |
$2,459.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,721.96
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,459.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,090.96
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,721.96
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,459.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,844.96
|
| Rate for Payer: SOMOS Essential |
$1,844.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,459.95
|
|
|
PR COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA
|
Professional
|
Both
|
$7,880.46
|
|
|
Service Code
|
HCPCS 44144
|
| Min. Negotiated Rate |
$1,455.38 |
| Max. Negotiated Rate |
$4,678.02 |
| Rate for Payer: Cash Price |
$2,098.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,079.12
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,871.21
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,871.21
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,975.16
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,079.12
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,975.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,079.12
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,079.12
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,559.34
|
| Rate for Payer: Healthfirst Commercial |
$2,079.12
|
| Rate for Payer: Healthfirst Essential Plan |
$4,678.02
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,975.16
|
| Rate for Payer: Healthfirst QHP |
$2,079.12
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,455.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,079.12
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,767.25
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,455.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,079.12
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,559.34
|
| Rate for Payer: SOMOS Essential |
$1,559.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,079.12
|
|
|
PR COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT
|
Professional
|
Both
|
$7,390.92
|
|
|
Service Code
|
HCPCS 44143
|
| Min. Negotiated Rate |
$1,364.34 |
| Max. Negotiated Rate |
$4,385.39 |
| Rate for Payer: Cash Price |
$1,968.37
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,949.06
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,754.15
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,754.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,851.61
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,949.06
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,851.61
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,949.06
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,949.06
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,461.80
|
| Rate for Payer: Healthfirst Commercial |
$1,949.06
|
| Rate for Payer: Healthfirst Essential Plan |
$4,385.39
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,851.61
|
| Rate for Payer: Healthfirst QHP |
$1,949.06
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,364.34
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,949.06
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,656.70
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,364.34
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,949.06
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,461.80
|
| Rate for Payer: SOMOS Essential |
$1,461.80
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,949.06
|
|
|
PR COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS
|
Professional
|
Both
|
$5,543.65
|
|
|
Service Code
|
HCPCS 44160
|
| Min. Negotiated Rate |
$1,028.64 |
| Max. Negotiated Rate |
$3,306.35 |
| Rate for Payer: Cash Price |
$1,481.09
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,469.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,322.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,322.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,396.02
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,469.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,396.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,469.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,469.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,102.12
|
| Rate for Payer: Healthfirst Commercial |
$1,469.49
|
| Rate for Payer: Healthfirst Essential Plan |
$3,306.35
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,396.02
|
| Rate for Payer: Healthfirst QHP |
$1,469.49
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,028.64
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,469.49
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,249.07
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,028.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,469.49
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,102.12
|
| Rate for Payer: SOMOS Essential |
$1,102.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,469.49
|
|
|
PR COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY
|
Professional
|
Both
|
$8,096.69
|
|
|
Service Code
|
HCPCS 44141
|
| Min. Negotiated Rate |
$1,494.71 |
| Max. Negotiated Rate |
$4,804.43 |
| Rate for Payer: Cash Price |
$2,161.35
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,135.30
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,921.77
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,921.77
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,028.54
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,135.30
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,028.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,135.30
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,135.30
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,601.47
|
| Rate for Payer: Healthfirst Commercial |
$2,135.30
|
| Rate for Payer: Healthfirst Essential Plan |
$4,804.43
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,028.54
|
| Rate for Payer: Healthfirst QHP |
$2,135.30
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,494.71
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,135.30
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,815.01
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,494.71
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,135.30
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,601.47
|
| Rate for Payer: SOMOS Essential |
$1,601.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,135.30
|
|
|
PR COLECTOMY TOT ABDL W/PROCTECTOMY W/CONTNT ILEOST
|
Professional
|
Both
|
$10,377.01
|
|
|
Service Code
|
HCPCS 44156
|
| Min. Negotiated Rate |
$1,912.10 |
| Max. Negotiated Rate |
$6,146.03 |
| Rate for Payer: Cash Price |
$2,759.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,731.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,458.41
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,458.41
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,594.99
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,731.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,594.99
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,731.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,731.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,048.68
|
| Rate for Payer: Healthfirst Commercial |
$2,731.57
|
| Rate for Payer: Healthfirst Essential Plan |
$6,146.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,594.99
|
| Rate for Payer: Healthfirst QHP |
$2,731.57
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,912.10
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,731.57
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,321.83
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,912.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,731.57
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,048.68
|
| Rate for Payer: SOMOS Essential |
$2,048.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,731.57
|
|
|
PR COLECTOMY TOT ABDL W/PROCTECTOMY W/ILEOSTOMY
|
Professional
|
Both
|
$9,067.07
|
|
|
Service Code
|
HCPCS 44155
|
| Min. Negotiated Rate |
$1,686.43 |
| Max. Negotiated Rate |
$5,420.65 |
| Rate for Payer: Cash Price |
$2,435.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,409.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,168.26
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,168.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,288.72
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,409.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,288.72
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,409.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,409.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,806.88
|
| Rate for Payer: Healthfirst Commercial |
$2,409.18
|
| Rate for Payer: Healthfirst Essential Plan |
$5,420.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,288.72
|
| Rate for Payer: Healthfirst QHP |
$2,409.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,686.43
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,409.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,047.80
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,686.43
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,409.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,806.88
|
| Rate for Payer: SOMOS Essential |
$1,806.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,409.18
|
|
|
PR COLECTOMY TOT ABD W/PROCTECTOMY ILEOANAL ANAST
|
Professional
|
Both
|
$9,861.36
|
|
|
Service Code
|
HCPCS 44157
|
| Min. Negotiated Rate |
$1,819.52 |
| Max. Negotiated Rate |
$5,848.47 |
| Rate for Payer: Cash Price |
$2,624.41
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,599.32
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,339.39
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,339.39
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,469.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,599.32
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,469.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,599.32
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,599.32
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,949.49
|
| Rate for Payer: Healthfirst Commercial |
$2,599.32
|
| Rate for Payer: Healthfirst Essential Plan |
$5,848.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,469.35
|
| Rate for Payer: Healthfirst QHP |
$2,599.32
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,819.52
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,599.32
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,209.42
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,819.52
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,599.32
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,949.49
|
| Rate for Payer: SOMOS Essential |
$1,949.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,599.32
|
|
|
PR COLLECT BLOOD FROM CATHETER VENOUS NOS
|
Professional
|
Both
|
$126.35
|
|
|
Service Code
|
HCPCS 36592
|
| Min. Negotiated Rate |
$24.35 |
| Max. Negotiated Rate |
$78.25 |
| Rate for Payer: Cash Price |
$35.60
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$34.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$31.30
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$31.30
|
| Rate for Payer: Fidelis Essential Plan QHP |
$33.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$34.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$33.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$34.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$34.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$26.09
|
| Rate for Payer: Healthfirst Commercial |
$34.78
|
| Rate for Payer: Healthfirst Essential Plan |
$78.25
|
| Rate for Payer: Healthfirst Medicare Advantage |
$33.04
|
| Rate for Payer: Healthfirst QHP |
$34.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$24.35
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$34.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$29.56
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$24.35
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$34.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26.09
|
| Rate for Payer: SOMOS Essential |
$26.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$34.78
|
|
|
PR COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE
|
Professional
|
Both
|
$116.31
|
|
|
Service Code
|
HCPCS 36591
|
| Min. Negotiated Rate |
$22.71 |
| Max. Negotiated Rate |
$73.01 |
| Rate for Payer: Cash Price |
$32.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$32.45
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$29.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$29.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$30.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$32.45
|
| Rate for Payer: Fidelis Qualified Health Plan |
$30.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$32.45
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$32.45
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$24.34
|
| Rate for Payer: Healthfirst Commercial |
$32.45
|
| Rate for Payer: Healthfirst Essential Plan |
$73.01
|
| Rate for Payer: Healthfirst Medicare Advantage |
$30.83
|
| Rate for Payer: Healthfirst QHP |
$32.45
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$22.71
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$32.45
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$27.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$22.71
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$32.45
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$24.34
|
| Rate for Payer: SOMOS Essential |
$24.34
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$32.45
|
|
|
PR COLLECTION VENOUS BLOOD VENIPUNCTURE
|
Professional
|
Both
|
$8.00
|
|
|
Service Code
|
HCPCS 36415
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$20.45 |
| Rate for Payer: Cash Price |
$8.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$9.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$8.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$8.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$8.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$9.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$8.64
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$9.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$9.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$6.82
|
| Rate for Payer: Healthfirst Commercial |
$9.09
|
| Rate for Payer: Healthfirst Essential Plan |
$20.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$8.64
|
| Rate for Payer: Healthfirst QHP |
$9.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$6.36
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$9.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$7.73
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$6.36
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$9.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3.64
|
| Rate for Payer: SOMOS Essential |
$3.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$9.09
|
|
|
PR COLLECT SWEAT FOR TEST
|
Professional
|
Both
|
$12.81
|
|
|
Service Code
|
HCPCS 89230
|
| Min. Negotiated Rate |
$2.60 |
| Max. Negotiated Rate |
$8.37 |
| Rate for Payer: Cash Price |
$3.77
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3.35
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3.53
|
| Rate for Payer: Fidelis Medicare Advantage |
$3.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2.79
|
| Rate for Payer: Healthfirst Commercial |
$3.72
|
| Rate for Payer: Healthfirst Essential Plan |
$8.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3.53
|
| Rate for Payer: Healthfirst QHP |
$3.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2.60
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3.72
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$3.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2.60
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3.72
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2.79
|
| Rate for Payer: SOMOS Essential |
$2.79
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3.72
|
|
|
PR COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D
|
Professional
|
Both
|
$220.05
|
|
|
Service Code
|
HCPCS 99091
|
| Min. Negotiated Rate |
$41.24 |
| Max. Negotiated Rate |
$132.55 |
| Rate for Payer: Amida Care Medicaid |
$48.48
|
| Rate for Payer: Cash Price |
$60.26
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$58.91
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$53.02
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$53.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$55.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$58.91
|
| Rate for Payer: Fidelis Qualified Health Plan |
$55.96
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$58.91
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$58.91
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$44.18
|
| Rate for Payer: Healthfirst Commercial |
$58.91
|
| Rate for Payer: Healthfirst Essential Plan |
$132.55
|
| Rate for Payer: Healthfirst Medicare Advantage |
$55.96
|
| Rate for Payer: Healthfirst QHP |
$58.91
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$41.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$58.91
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$50.07
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$41.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$58.91
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$44.18
|
| Rate for Payer: SOMOS Essential |
$44.18
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$58.91
|
|
|
PR COLON CA SCREEN;BARIUM ENEMA
|
Professional
|
Both
|
$955.82
|
|
|
Service Code
|
HCPCS G0106
|
| Rate for Payer: Cash Price |
$254.22
|
|
|
PR COLON CA SCREEN;BARIUM ENEMA
|
Professional
|
Both
|
$241.64
|
|
|
Service Code
|
HCPCS G0106 26
|
| Rate for Payer: Cash Price |
$64.98
|
|
|
PR COLON CA SCREEN;BARIUM ENEMA
|
Professional
|
Both
|
$714.14
|
|
|
Service Code
|
HCPCS G0106 TC
|
| Rate for Payer: Cash Price |
$189.23
|
|
|
PR COLON CA SCRN; BARIUM ENEMA
|
Professional
|
Both
|
$241.64
|
|
|
Service Code
|
HCPCS G0120 26
|
| Rate for Payer: Cash Price |
$64.98
|
|
|
PR COLON CA SCRN; BARIUM ENEMA
|
Professional
|
Both
|
$714.14
|
|
|
Service Code
|
HCPCS G0120 TC
|
| Rate for Payer: Cash Price |
$189.23
|
|
|
PR COLON CA SCRN; BARIUM ENEMA
|
Professional
|
Both
|
$955.82
|
|
|
Service Code
|
HCPCS G0120
|
| Rate for Payer: Cash Price |
$254.22
|
|
|
PR COLON CA SCRN NOT HI RSK IND
|
Professional
|
Both
|
$776.09
|
|
|
Service Code
|
HCPCS G0121
|
| Min. Negotiated Rate |
$146.29 |
| Max. Negotiated Rate |
$470.20 |
| Rate for Payer: Cash Price |
$210.14
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$208.98
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$188.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$188.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$198.53
|
| Rate for Payer: Fidelis Medicare Advantage |
$208.98
|
| Rate for Payer: Fidelis Qualified Health Plan |
$198.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$208.98
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$208.98
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$156.74
|
| Rate for Payer: Healthfirst Commercial |
$208.98
|
| Rate for Payer: Healthfirst Essential Plan |
$470.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$198.53
|
| Rate for Payer: Healthfirst QHP |
$208.98
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$146.29
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$208.98
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$177.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$146.29
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$208.98
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$156.74
|
| Rate for Payer: SOMOS Essential |
$156.74
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$208.98
|
|
|
PR COLON MOTILITY STDY MIN 6 HR CONT RECORD W/I&R
|
Professional
|
Both
|
$553.04
|
|
|
Service Code
|
HCPCS 91117
|
| Min. Negotiated Rate |
$59.32 |
| Max. Negotiated Rate |
$336.17 |
| Rate for Payer: Amida Care Medicaid |
$59.32
|
| Rate for Payer: Cash Price |
$151.09
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$149.41
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$134.47
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$134.47
|
| Rate for Payer: Fidelis Essential Plan QHP |
$141.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$149.41
|
| Rate for Payer: Fidelis Qualified Health Plan |
$141.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$149.41
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$149.41
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$112.06
|
| Rate for Payer: Healthfirst Commercial |
$149.41
|
| Rate for Payer: Healthfirst Essential Plan |
$336.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$141.94
|
| Rate for Payer: Healthfirst QHP |
$149.41
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$104.59
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$149.41
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$127.00
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$104.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$149.41
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$112.06
|
| Rate for Payer: SOMOS Essential |
$112.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$149.41
|
|
