|
PR COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S)
|
Professional
|
Both
|
$1,001.60
|
|
|
Service Code
|
HCPCS 45398
|
| Min. Negotiated Rate |
$186.68 |
| Max. Negotiated Rate |
$600.05 |
| Rate for Payer: Cash Price |
$269.19
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$266.69
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$240.02
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$240.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$253.36
|
| Rate for Payer: Fidelis Medicare Advantage |
$266.69
|
| Rate for Payer: Fidelis Qualified Health Plan |
$253.36
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$266.69
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$266.69
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$200.02
|
| Rate for Payer: Healthfirst Commercial |
$266.69
|
| Rate for Payer: Healthfirst Essential Plan |
$600.05
|
| Rate for Payer: Healthfirst Medicare Advantage |
$253.36
|
| Rate for Payer: Healthfirst QHP |
$266.69
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$186.68
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$266.69
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$226.69
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$186.68
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$266.69
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$200.02
|
| Rate for Payer: SOMOS Essential |
$200.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$266.69
|
|
|
PR COLONOSCOPY FLEXIBLE WITH DECOMPRESSION
|
Professional
|
Both
|
$1,050.91
|
|
|
Service Code
|
HCPCS 45393
|
| Min. Negotiated Rate |
$196.97 |
| Max. Negotiated Rate |
$633.11 |
| Rate for Payer: Cash Price |
$284.68
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$281.38
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$253.24
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$253.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$267.31
|
| Rate for Payer: Fidelis Medicare Advantage |
$281.38
|
| Rate for Payer: Fidelis Qualified Health Plan |
$267.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$281.38
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$281.38
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$211.03
|
| Rate for Payer: Healthfirst Commercial |
$281.38
|
| Rate for Payer: Healthfirst Essential Plan |
$633.11
|
| Rate for Payer: Healthfirst Medicare Advantage |
$267.31
|
| Rate for Payer: Healthfirst QHP |
$281.38
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$196.97
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$281.38
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$239.17
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$196.97
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$281.38
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$211.03
|
| Rate for Payer: SOMOS Essential |
$211.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$281.38
|
|
|
PR COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES
|
Professional
|
Both
|
$1,135.65
|
|
|
Service Code
|
HCPCS 45388
|
| Min. Negotiated Rate |
$212.32 |
| Max. Negotiated Rate |
$682.47 |
| Rate for Payer: Cash Price |
$306.26
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$303.32
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$272.99
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$272.99
|
| Rate for Payer: Fidelis Essential Plan QHP |
$288.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$303.32
|
| Rate for Payer: Fidelis Qualified Health Plan |
$288.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$303.32
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$303.32
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$227.49
|
| Rate for Payer: Healthfirst Commercial |
$303.32
|
| Rate for Payer: Healthfirst Essential Plan |
$682.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$288.15
|
| Rate for Payer: Healthfirst QHP |
$303.32
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$212.32
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$303.32
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$257.82
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$212.32
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$303.32
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$227.49
|
| Rate for Payer: SOMOS Essential |
$227.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$303.32
|
|
|
PR COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD
|
Professional
|
Both
|
$773.36
|
|
|
Service Code
|
HCPCS 45378
|
| Min. Negotiated Rate |
$145.85 |
| Max. Negotiated Rate |
$468.81 |
| Rate for Payer: Cash Price |
$209.51
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$208.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$187.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$187.52
|
| Rate for Payer: Fidelis Essential Plan QHP |
$197.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$208.36
|
| Rate for Payer: Fidelis Qualified Health Plan |
$197.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$208.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$208.36
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$156.27
|
| Rate for Payer: Healthfirst Commercial |
$208.36
|
| Rate for Payer: Healthfirst Essential Plan |
$468.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$197.94
|
| Rate for Payer: Healthfirst QHP |
$208.36
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$145.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$208.36
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$177.11
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$145.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$208.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$156.27
|
| Rate for Payer: SOMOS Essential |
$156.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$208.36
|
|
|
PR COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION
|
Professional
|
Both
|
$1,380.58
|
|
|
Service Code
|
HCPCS 45390
|
| Min. Negotiated Rate |
$259.25 |
| Max. Negotiated Rate |
$833.29 |
| Rate for Payer: Cash Price |
$374.74
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$370.35
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$333.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$333.31
|
| Rate for Payer: Fidelis Essential Plan QHP |
$351.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$370.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$351.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$370.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$370.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$277.76
|
| Rate for Payer: Healthfirst Commercial |
$370.35
|
| Rate for Payer: Healthfirst Essential Plan |
$833.29
|
| Rate for Payer: Healthfirst Medicare Advantage |
$351.83
|
| Rate for Payer: Healthfirst QHP |
$370.35
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$259.25
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$370.35
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$314.80
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$259.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$370.35
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$277.76
|
| Rate for Payer: SOMOS Essential |
$277.76
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$370.35
|
|
|
PR COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT
|
Professional
|
Both
|
$1,210.79
|
|
|
Service Code
|
HCPCS 45389
|
| Min. Negotiated Rate |
$226.16 |
| Max. Negotiated Rate |
$726.95 |
| Rate for Payer: Cash Price |
$326.67
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$323.09
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$290.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$290.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$306.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$323.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$306.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$323.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$323.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$242.32
|
| Rate for Payer: Healthfirst Commercial |
$323.09
|
| Rate for Payer: Healthfirst Essential Plan |
$726.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$306.94
|
| Rate for Payer: Healthfirst QHP |
$323.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$226.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$323.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$274.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$226.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$323.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$242.32
|
| Rate for Payer: SOMOS Essential |
$242.32
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$323.09
|
|
|
PR COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S)
|
Professional
|
Both
|
$995.89
|
|
|
Service Code
|
HCPCS 45379
|
| Min. Negotiated Rate |
$186.84 |
| Max. Negotiated Rate |
$600.57 |
| Rate for Payer: Cash Price |
$269.42
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$266.92
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$240.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$240.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$253.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$266.92
|
| Rate for Payer: Fidelis Qualified Health Plan |
$253.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$266.92
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$266.92
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$200.19
|
| Rate for Payer: Healthfirst Commercial |
$266.92
|
| Rate for Payer: Healthfirst Essential Plan |
$600.57
|
| Rate for Payer: Healthfirst Medicare Advantage |
$253.57
|
| Rate for Payer: Healthfirst QHP |
$266.92
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$186.84
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$266.92
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$226.88
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$186.84
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$266.92
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$200.19
|
| Rate for Payer: SOMOS Essential |
$200.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$266.92
|
|
|
PR COLONOSCOPY STOMA ABLATION LESION
|
Professional
|
Both
|
$1,008.00
|
|
|
Service Code
|
HCPCS 44401
|
| Min. Negotiated Rate |
$189.22 |
| Max. Negotiated Rate |
$608.20 |
| Rate for Payer: Cash Price |
$273.24
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$270.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$243.28
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$243.28
|
| Rate for Payer: Fidelis Essential Plan QHP |
$256.79
|
| Rate for Payer: Fidelis Medicare Advantage |
$270.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$256.79
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$270.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$270.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$202.73
|
| Rate for Payer: Healthfirst Commercial |
$270.31
|
| Rate for Payer: Healthfirst Essential Plan |
$608.20
|
| Rate for Payer: Healthfirst Medicare Advantage |
$256.79
|
| Rate for Payer: Healthfirst QHP |
$270.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$189.22
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$270.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$229.76
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$189.22
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$270.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$202.73
|
| Rate for Payer: SOMOS Essential |
$202.73
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$270.31
|
|
|
PR COLONOSCOPY STOMA CONTROL BLEEDING
|
Professional
|
Both
|
$963.20
|
|
|
Service Code
|
HCPCS 44391
|
| Min. Negotiated Rate |
$180.38 |
| Max. Negotiated Rate |
$579.80 |
| Rate for Payer: Cash Price |
$260.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$257.69
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$231.92
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$231.92
|
| Rate for Payer: Fidelis Essential Plan QHP |
$244.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$257.69
|
| Rate for Payer: Fidelis Qualified Health Plan |
$244.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$257.69
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$257.69
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$193.27
|
| Rate for Payer: Healthfirst Commercial |
$257.69
|
| Rate for Payer: Healthfirst Essential Plan |
$579.80
|
| Rate for Payer: Healthfirst Medicare Advantage |
$244.81
|
| Rate for Payer: Healthfirst QHP |
$257.69
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$180.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$257.69
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$219.04
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$180.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$257.69
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$193.27
|
| Rate for Payer: SOMOS Essential |
$193.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$257.69
|
|
|
PR COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX
|
Professional
|
Both
|
$664.16
|
|
|
Service Code
|
HCPCS 44388
|
| Min. Negotiated Rate |
$124.80 |
| Max. Negotiated Rate |
$401.13 |
| Rate for Payer: Cash Price |
$179.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$178.28
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$160.45
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$160.45
|
| Rate for Payer: Fidelis Essential Plan QHP |
$169.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$178.28
|
| Rate for Payer: Fidelis Qualified Health Plan |
$169.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$178.28
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$178.28
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$133.71
|
| Rate for Payer: Healthfirst Commercial |
$178.28
|
| Rate for Payer: Healthfirst Essential Plan |
$401.13
|
| Rate for Payer: Healthfirst Medicare Advantage |
$169.37
|
| Rate for Payer: Healthfirst QHP |
$178.28
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$124.80
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$178.28
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$151.54
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$124.80
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$178.28
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$133.71
|
| Rate for Payer: SOMOS Essential |
$133.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$178.28
|
|
|
PR COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS
|
Professional
|
Both
|
$851.24
|
|
|
Service Code
|
HCPCS 44392
|
| Min. Negotiated Rate |
$160.26 |
| Max. Negotiated Rate |
$515.14 |
| Rate for Payer: Cash Price |
$230.59
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$228.95
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$206.06
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$206.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$217.50
|
| Rate for Payer: Fidelis Medicare Advantage |
$228.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$217.50
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$228.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$228.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$171.71
|
| Rate for Payer: Healthfirst Commercial |
$228.95
|
| Rate for Payer: Healthfirst Essential Plan |
$515.14
|
| Rate for Payer: Healthfirst Medicare Advantage |
$217.50
|
| Rate for Payer: Healthfirst QHP |
$228.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$160.26
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$228.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$194.61
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$160.26
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$228.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$171.71
|
| Rate for Payer: SOMOS Essential |
$171.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$228.95
|
|
|
PR COLONOSCOPY STOMA W/BALLOON DILATION
|
Professional
|
Both
|
$760.24
|
|
|
Service Code
|
HCPCS 44405
|
| Min. Negotiated Rate |
$143.94 |
| Max. Negotiated Rate |
$462.67 |
| Rate for Payer: Cash Price |
$207.38
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$205.63
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$185.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$185.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$195.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$205.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$195.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$205.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$205.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$154.22
|
| Rate for Payer: Healthfirst Commercial |
$205.63
|
| Rate for Payer: Healthfirst Essential Plan |
$462.67
|
| Rate for Payer: Healthfirst Medicare Advantage |
$195.35
|
| Rate for Payer: Healthfirst QHP |
$205.63
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$143.94
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$205.63
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$174.79
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$143.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$205.63
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$154.22
|
| Rate for Payer: SOMOS Essential |
$154.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$205.63
|
|
|
PR COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$723.31
|
|
|
Service Code
|
HCPCS 44389
|
| Min. Negotiated Rate |
$136.10 |
| Max. Negotiated Rate |
$437.47 |
| Rate for Payer: Cash Price |
$195.18
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$194.43
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$174.99
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$174.99
|
| Rate for Payer: Fidelis Essential Plan QHP |
$184.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$194.43
|
| Rate for Payer: Fidelis Qualified Health Plan |
$184.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$194.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$194.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$145.82
|
| Rate for Payer: Healthfirst Commercial |
$194.43
|
| Rate for Payer: Healthfirst Essential Plan |
$437.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$184.71
|
| Rate for Payer: Healthfirst QHP |
$194.43
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$136.10
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$194.43
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$165.27
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$136.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$194.43
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$145.82
|
| Rate for Payer: SOMOS Essential |
$145.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$194.43
|
|
|
PR COLONOSCOPY STOMA W/ENDOSCOPIC MUCOSAL RESCJ
|
Professional
|
Both
|
$1,264.90
|
|
|
Service Code
|
HCPCS 44403
|
| Min. Negotiated Rate |
$236.94 |
| Max. Negotiated Rate |
$761.60 |
| Rate for Payer: Cash Price |
$343.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$338.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$304.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$304.64
|
| Rate for Payer: Fidelis Essential Plan QHP |
$321.57
|
| Rate for Payer: Fidelis Medicare Advantage |
$338.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$321.57
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$338.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$338.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$253.87
|
| Rate for Payer: Healthfirst Commercial |
$338.49
|
| Rate for Payer: Healthfirst Essential Plan |
$761.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$321.57
|
| Rate for Payer: Healthfirst QHP |
$338.49
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$236.94
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$338.49
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$287.72
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$236.94
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$338.49
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$253.87
|
| Rate for Payer: SOMOS Essential |
$253.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$338.49
|
|
|
PR COLONOSCOPY STOMA W/ENDOSCOPIC STENT PLCMT
|
Professional
|
Both
|
$1,087.03
|
|
|
Service Code
|
HCPCS 44402
|
| Min. Negotiated Rate |
$203.98 |
| Max. Negotiated Rate |
$655.65 |
| Rate for Payer: Cash Price |
$294.58
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$291.40
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$262.26
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$262.26
|
| Rate for Payer: Fidelis Essential Plan QHP |
$276.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$291.40
|
| Rate for Payer: Fidelis Qualified Health Plan |
$276.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$291.40
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$291.40
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$218.55
|
| Rate for Payer: Healthfirst Commercial |
$291.40
|
| Rate for Payer: Healthfirst Essential Plan |
$655.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$276.83
|
| Rate for Payer: Healthfirst QHP |
$291.40
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$203.98
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$291.40
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$247.69
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$203.98
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$291.40
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$218.55
|
| Rate for Payer: SOMOS Essential |
$218.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$291.40
|
|
|
PR COLONOSCOPY STOMA W/ENDOSCOPIC ULTRASOUND EXAM
|
Professional
|
Both
|
$951.16
|
|
|
Service Code
|
HCPCS 44406
|
| Min. Negotiated Rate |
$180.00 |
| Max. Negotiated Rate |
$578.59 |
| Rate for Payer: Cash Price |
$258.67
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$257.15
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$231.44
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$231.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$244.29
|
| Rate for Payer: Fidelis Medicare Advantage |
$257.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$244.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$257.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$257.15
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$192.86
|
| Rate for Payer: Healthfirst Commercial |
$257.15
|
| Rate for Payer: Healthfirst Essential Plan |
$578.59
|
| Rate for Payer: Healthfirst Medicare Advantage |
$244.29
|
| Rate for Payer: Healthfirst QHP |
$257.15
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$180.00
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$257.15
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$218.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$180.00
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$257.15
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$192.86
|
| Rate for Payer: SOMOS Essential |
$192.86
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$257.15
|
|
|
PR COLONOSCOPY STOMA W/RMVL FOREIGN BODY
|
Professional
|
Both
|
$874.90
|
|
|
Service Code
|
HCPCS 44390
|
| Min. Negotiated Rate |
$165.68 |
| Max. Negotiated Rate |
$532.55 |
| Rate for Payer: Cash Price |
$237.33
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$236.69
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$213.02
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$213.02
|
| Rate for Payer: Fidelis Essential Plan QHP |
$224.86
|
| Rate for Payer: Fidelis Medicare Advantage |
$236.69
|
| Rate for Payer: Fidelis Qualified Health Plan |
$224.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$236.69
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$236.69
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$177.52
|
| Rate for Payer: Healthfirst Commercial |
$236.69
|
| Rate for Payer: Healthfirst Essential Plan |
$532.55
|
| Rate for Payer: Healthfirst Medicare Advantage |
$224.86
|
| Rate for Payer: Healthfirst QHP |
$236.69
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$165.68
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$236.69
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$201.19
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$165.68
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$236.69
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$177.52
|
| Rate for Payer: SOMOS Essential |
$177.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$236.69
|
|
|
PR COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE
|
Professional
|
Both
|
$947.21
|
|
|
Service Code
|
HCPCS 44394
|
| Min. Negotiated Rate |
$177.60 |
| Max. Negotiated Rate |
$570.87 |
| Rate for Payer: Cash Price |
$256.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$253.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$228.35
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$228.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$241.03
|
| Rate for Payer: Fidelis Medicare Advantage |
$253.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$241.03
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$253.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$253.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$190.29
|
| Rate for Payer: Healthfirst Commercial |
$253.72
|
| Rate for Payer: Healthfirst Essential Plan |
$570.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$241.03
|
| Rate for Payer: Healthfirst QHP |
$253.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$177.60
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$253.72
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$215.66
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$177.60
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$253.72
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$190.29
|
| Rate for Payer: SOMOS Essential |
$190.29
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$253.72
|
|
|
PR COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION
|
Professional
|
Both
|
$724.75
|
|
|
Service Code
|
HCPCS 44404
|
| Min. Negotiated Rate |
$136.10 |
| Max. Negotiated Rate |
$437.47 |
| Rate for Payer: Cash Price |
$195.18
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$194.43
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$174.99
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$174.99
|
| Rate for Payer: Fidelis Essential Plan QHP |
$184.71
|
| Rate for Payer: Fidelis Medicare Advantage |
$194.43
|
| Rate for Payer: Fidelis Qualified Health Plan |
$184.71
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$194.43
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$194.43
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$145.82
|
| Rate for Payer: Healthfirst Commercial |
$194.43
|
| Rate for Payer: Healthfirst Essential Plan |
$437.47
|
| Rate for Payer: Healthfirst Medicare Advantage |
$184.71
|
| Rate for Payer: Healthfirst QHP |
$194.43
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$136.10
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$194.43
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$165.27
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$136.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$194.43
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$145.82
|
| Rate for Payer: SOMOS Essential |
$145.82
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$194.43
|
|
|
PR COLONOSCOPY STOMA W/US GID NDL ASPIR/BX
|
Professional
|
Both
|
$1,143.63
|
|
|
Service Code
|
HCPCS 44407
|
| Min. Negotiated Rate |
$215.24 |
| Max. Negotiated Rate |
$691.83 |
| Rate for Payer: Cash Price |
$309.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$307.48
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$276.73
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$276.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$292.11
|
| Rate for Payer: Fidelis Medicare Advantage |
$307.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$292.11
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$307.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$307.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$230.61
|
| Rate for Payer: Healthfirst Commercial |
$307.48
|
| Rate for Payer: Healthfirst Essential Plan |
$691.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$292.11
|
| Rate for Payer: Healthfirst QHP |
$307.48
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$215.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$307.48
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$261.36
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$215.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$307.48
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$230.61
|
| Rate for Payer: SOMOS Essential |
$230.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$307.48
|
|
|
PR COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION
|
Professional
|
Both
|
$959.07
|
|
|
Service Code
|
HCPCS 44408
|
| Min. Negotiated Rate |
$181.52 |
| Max. Negotiated Rate |
$583.45 |
| Rate for Payer: Cash Price |
$260.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$259.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$233.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$233.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$246.34
|
| Rate for Payer: Fidelis Medicare Advantage |
$259.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$246.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$259.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$259.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$194.48
|
| Rate for Payer: Healthfirst Commercial |
$259.31
|
| Rate for Payer: Healthfirst Essential Plan |
$583.45
|
| Rate for Payer: Healthfirst Medicare Advantage |
$246.34
|
| Rate for Payer: Healthfirst QHP |
$259.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$181.52
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$259.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$220.41
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$181.52
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$259.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$194.48
|
| Rate for Payer: SOMOS Essential |
$194.48
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$259.31
|
|
|
PR COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE
|
Professional
|
Both
|
$837.97
|
|
|
Service Code
|
HCPCS 45380
|
| Min. Negotiated Rate |
$158.63 |
| Max. Negotiated Rate |
$509.87 |
| Rate for Payer: Cash Price |
$227.12
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$226.61
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$203.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$203.95
|
| Rate for Payer: Fidelis Essential Plan QHP |
$215.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$226.61
|
| Rate for Payer: Fidelis Qualified Health Plan |
$215.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$226.61
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$226.61
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$169.96
|
| Rate for Payer: Healthfirst Commercial |
$226.61
|
| Rate for Payer: Healthfirst Essential Plan |
$509.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$215.28
|
| Rate for Payer: Healthfirst QHP |
$226.61
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$158.63
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$226.61
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$192.62
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$158.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$226.61
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$169.96
|
| Rate for Payer: SOMOS Essential |
$169.96
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$226.61
|
|
|
PR COLORECTAL SCRN; HI RISK IND
|
Professional
|
Both
|
$773.36
|
|
|
Service Code
|
HCPCS G0105
|
| Min. Negotiated Rate |
$145.85 |
| Max. Negotiated Rate |
$468.81 |
| Rate for Payer: Cash Price |
$209.51
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$208.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$187.52
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$187.52
|
| Rate for Payer: Fidelis Essential Plan QHP |
$197.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$208.36
|
| Rate for Payer: Fidelis Qualified Health Plan |
$197.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$208.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$208.36
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$156.27
|
| Rate for Payer: Healthfirst Commercial |
$208.36
|
| Rate for Payer: Healthfirst Essential Plan |
$468.81
|
| Rate for Payer: Healthfirst Medicare Advantage |
$197.94
|
| Rate for Payer: Healthfirst QHP |
$208.36
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$145.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$208.36
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$177.11
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$145.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$208.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$156.27
|
| Rate for Payer: SOMOS Essential |
$156.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$208.36
|
|
|
PR COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV
|
Professional
|
Both
|
$195.37
|
|
|
Service Code
|
HCPCS 92283 TC
|
| Min. Negotiated Rate |
$37.39 |
| Max. Negotiated Rate |
$120.17 |
| Rate for Payer: Cash Price |
$54.46
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$53.41
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$48.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$48.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$50.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$53.41
|
| Rate for Payer: Fidelis Qualified Health Plan |
$50.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$53.41
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$53.41
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$40.06
|
| Rate for Payer: Healthfirst Commercial |
$53.41
|
| Rate for Payer: Healthfirst Essential Plan |
$120.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$50.74
|
| Rate for Payer: Healthfirst QHP |
$53.41
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$37.39
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$53.41
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$45.40
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$37.39
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$53.41
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$40.06
|
| Rate for Payer: SOMOS Essential |
$40.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$53.41
|
|
|
PR COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV
|
Professional
|
Both
|
$230.90
|
|
|
Service Code
|
HCPCS 92283
|
| Min. Negotiated Rate |
$44.09 |
| Max. Negotiated Rate |
$141.73 |
| Rate for Payer: Cash Price |
$63.76
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$62.99
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$56.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$56.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$59.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$62.99
|
| Rate for Payer: Fidelis Qualified Health Plan |
$59.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$62.99
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$62.99
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$47.24
|
| Rate for Payer: Healthfirst Commercial |
$62.99
|
| Rate for Payer: Healthfirst Essential Plan |
$141.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$59.84
|
| Rate for Payer: Healthfirst QHP |
$62.99
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$44.09
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$62.99
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$53.54
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$44.09
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$62.99
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$47.24
|
| Rate for Payer: SOMOS Essential |
$47.24
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$62.99
|
|
