|
PR CRANIECTOMY CRANIOSYNOSTOSIS BIFRONTAL BONE FLAP
|
Professional
|
Both
|
$8,134.42
|
|
|
Service Code
|
HCPCS 61557
|
| Min. Negotiated Rate |
$1,490.17 |
| Max. Negotiated Rate |
$4,789.82 |
| Rate for Payer: Cash Price |
$2,148.18
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,128.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,915.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,915.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,022.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,128.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,022.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,128.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,128.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,596.61
|
| Rate for Payer: Healthfirst Commercial |
$2,128.81
|
| Rate for Payer: Healthfirst Essential Plan |
$4,789.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,022.37
|
| Rate for Payer: Healthfirst QHP |
$2,128.81
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,490.17
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,128.81
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,809.49
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,490.17
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,128.81
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,596.61
|
| Rate for Payer: SOMOS Essential |
$1,596.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,128.81
|
|
|
PR CRANIECTOMY/CRANIOTMY DRG ABSCESS INFRATENTORIAL
|
Professional
|
Both
|
$10,258.99
|
|
|
Service Code
|
HCPCS 61321
|
| Min. Negotiated Rate |
$1,873.64 |
| Max. Negotiated Rate |
$6,022.42 |
| Rate for Payer: Cash Price |
$2,702.65
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,676.63
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,408.97
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,408.97
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,542.80
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,676.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,542.80
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,676.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,676.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,007.47
|
| Rate for Payer: Healthfirst Commercial |
$2,676.63
|
| Rate for Payer: Healthfirst Essential Plan |
$6,022.42
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,542.80
|
| Rate for Payer: Healthfirst QHP |
$2,676.63
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,873.64
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,676.63
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,275.14
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,873.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,676.63
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,007.47
|
| Rate for Payer: SOMOS Essential |
$2,007.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,676.63
|
|
|
PR CRANIECTOMY/CRANIOTMY DRG ABSCESS SUPRATENTORIAL
|
Professional
|
Both
|
$9,120.27
|
|
|
Service Code
|
HCPCS 61320
|
| Min. Negotiated Rate |
$1,671.33 |
| Max. Negotiated Rate |
$5,372.15 |
| Rate for Payer: Cash Price |
$2,406.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,387.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,148.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,148.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,268.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,387.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,268.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,387.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,387.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,790.71
|
| Rate for Payer: Healthfirst Commercial |
$2,387.62
|
| Rate for Payer: Healthfirst Essential Plan |
$5,372.15
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,268.24
|
| Rate for Payer: Healthfirst QHP |
$2,387.62
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,671.33
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,387.62
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,029.48
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,671.33
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,387.62
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,790.71
|
| Rate for Payer: SOMOS Essential |
$1,790.71
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,387.62
|
|
|
PR CRANIECTOMY/CRANIOTOMY EXC FOREIGN BODY BRAIN
|
Professional
|
Both
|
$9,037.53
|
|
|
Service Code
|
HCPCS 61570
|
| Min. Negotiated Rate |
$1,651.18 |
| Max. Negotiated Rate |
$5,307.37 |
| Rate for Payer: Cash Price |
$2,383.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,358.83
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,122.95
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,122.95
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,240.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,358.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,240.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,358.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,358.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,769.12
|
| Rate for Payer: Healthfirst Commercial |
$2,358.83
|
| Rate for Payer: Healthfirst Essential Plan |
$5,307.37
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,240.89
|
| Rate for Payer: Healthfirst QHP |
$2,358.83
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,651.18
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,358.83
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,005.01
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,651.18
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,358.83
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,769.12
|
| Rate for Payer: SOMOS Essential |
$1,769.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,358.83
|
|
|
PR CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL
|
Professional
|
Both
|
$9,682.09
|
|
|
Service Code
|
HCPCS 61305
|
| Min. Negotiated Rate |
$1,769.31 |
| Max. Negotiated Rate |
$5,687.08 |
| Rate for Payer: Cash Price |
$2,551.55
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,527.59
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,274.83
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,274.83
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,401.21
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,527.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,401.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,527.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,527.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,895.69
|
| Rate for Payer: Healthfirst Commercial |
$2,527.59
|
| Rate for Payer: Healthfirst Essential Plan |
$5,687.08
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,401.21
|
| Rate for Payer: Healthfirst QHP |
$2,527.59
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,769.31
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,527.59
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,148.45
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,769.31
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,527.59
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,895.69
|
| Rate for Payer: SOMOS Essential |
$1,895.69
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,527.59
|
|
|
PR CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL
|
Professional
|
Both
|
$7,868.39
|
|
|
Service Code
|
HCPCS 61304
|
| Min. Negotiated Rate |
$1,444.67 |
| Max. Negotiated Rate |
$4,643.60 |
| Rate for Payer: Cash Price |
$2,082.88
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,063.82
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,857.44
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,857.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,960.63
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,063.82
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,960.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,063.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,063.82
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,547.87
|
| Rate for Payer: Healthfirst Commercial |
$2,063.82
|
| Rate for Payer: Healthfirst Essential Plan |
$4,643.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,960.63
|
| Rate for Payer: Healthfirst QHP |
$2,063.82
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,444.67
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,063.82
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,754.25
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,444.67
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,063.82
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,547.87
|
| Rate for Payer: SOMOS Essential |
$1,547.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,063.82
|
|
|
PR CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN
|
Professional
|
Both
|
$9,614.22
|
|
|
Service Code
|
HCPCS 61571
|
| Min. Negotiated Rate |
$1,757.24 |
| Max. Negotiated Rate |
$5,648.27 |
| Rate for Payer: Cash Price |
$2,534.71
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,510.34
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,259.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,259.31
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,384.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,510.34
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,384.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,510.34
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,510.34
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,882.76
|
| Rate for Payer: Healthfirst Commercial |
$2,510.34
|
| Rate for Payer: Healthfirst Essential Plan |
$5,648.27
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,384.82
|
| Rate for Payer: Healthfirst QHP |
$2,510.34
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,757.24
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,510.34
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,133.79
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,757.24
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,510.34
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,882.76
|
| Rate for Payer: SOMOS Essential |
$1,882.76
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,510.34
|
|
|
PR CRANIECTOMY HMTMA INFRATENTORIAL EXTRA/SUBDURAL
|
Professional
|
Both
|
$8,767.71
|
|
|
Service Code
|
HCPCS 61314
|
| Min. Negotiated Rate |
$1,608.73 |
| Max. Negotiated Rate |
$5,170.93 |
| Rate for Payer: Cash Price |
$2,319.33
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,298.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,068.37
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,068.37
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,183.28
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,298.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,183.28
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,298.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,298.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,723.64
|
| Rate for Payer: Healthfirst Commercial |
$2,298.19
|
| Rate for Payer: Healthfirst Essential Plan |
$5,170.93
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,183.28
|
| Rate for Payer: Healthfirst QHP |
$2,298.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,608.73
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,298.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,953.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,608.73
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,298.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,723.64
|
| Rate for Payer: SOMOS Essential |
$1,723.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,298.19
|
|
|
PR CRANIECTOMY HMTMA SUPRATENTORIAL EXTRA/SUBDURAL
|
Professional
|
Both
|
$9,995.58
|
|
|
Service Code
|
HCPCS 61312
|
| Min. Negotiated Rate |
$1,823.00 |
| Max. Negotiated Rate |
$5,859.65 |
| Rate for Payer: Cash Price |
$2,632.48
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,604.29
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,343.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,343.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,474.08
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,604.29
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,474.08
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,604.29
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,604.29
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,953.22
|
| Rate for Payer: Healthfirst Commercial |
$2,604.29
|
| Rate for Payer: Healthfirst Essential Plan |
$5,859.65
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,474.08
|
| Rate for Payer: Healthfirst QHP |
$2,604.29
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,823.00
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,604.29
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,213.65
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,823.00
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,604.29
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,953.22
|
| Rate for Payer: SOMOS Essential |
$1,953.22
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,604.29
|
|
|
PR CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL
|
Professional
|
Both
|
$9,980.25
|
|
|
Service Code
|
HCPCS 61315
|
| Min. Negotiated Rate |
$1,822.18 |
| Max. Negotiated Rate |
$5,857.00 |
| Rate for Payer: Cash Price |
$2,633.56
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,603.11
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,342.80
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,342.80
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,472.95
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,603.11
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,472.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,603.11
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,603.11
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,952.33
|
| Rate for Payer: Healthfirst Commercial |
$2,603.11
|
| Rate for Payer: Healthfirst Essential Plan |
$5,857.00
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,472.95
|
| Rate for Payer: Healthfirst QHP |
$2,603.11
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,822.18
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,603.11
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,212.64
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,822.18
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,603.11
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,952.33
|
| Rate for Payer: SOMOS Essential |
$1,952.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,603.11
|
|
|
PR CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL
|
Professional
|
Both
|
$9,554.27
|
|
|
Service Code
|
HCPCS 61313
|
| Min. Negotiated Rate |
$1,750.29 |
| Max. Negotiated Rate |
$5,625.94 |
| Rate for Payer: Cash Price |
$2,525.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,500.42
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,250.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,250.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,375.40
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,500.42
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,375.40
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,500.42
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,500.42
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,875.32
|
| Rate for Payer: Healthfirst Commercial |
$2,500.42
|
| Rate for Payer: Healthfirst Essential Plan |
$5,625.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,375.40
|
| Rate for Payer: Healthfirst QHP |
$2,500.42
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,750.29
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,500.42
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,125.36
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,750.29
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,500.42
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,875.32
|
| Rate for Payer: SOMOS Essential |
$1,875.32
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,500.42
|
|
|
PR CRANIECTOMY OSTEOMYELITIS
|
Professional
|
Both
|
$5,225.01
|
|
|
Service Code
|
HCPCS 61501
|
| Min. Negotiated Rate |
$963.15 |
| Max. Negotiated Rate |
$3,095.84 |
| Rate for Payer: Cash Price |
$1,386.15
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,375.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,238.34
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,238.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,307.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,375.93
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,307.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,375.93
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,375.93
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,031.95
|
| Rate for Payer: Healthfirst Commercial |
$1,375.93
|
| Rate for Payer: Healthfirst Essential Plan |
$3,095.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,307.13
|
| Rate for Payer: Healthfirst QHP |
$1,375.93
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$963.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,375.93
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,169.54
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$963.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,375.93
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,031.95
|
| Rate for Payer: SOMOS Essential |
$1,031.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,375.93
|
|
|
PR CRANIECTOMY SUBOCCIPITAL SECTION 1/> CRANIAL NR
|
Professional
|
Both
|
$10,171.18
|
|
|
Service Code
|
HCPCS 61460
|
| Min. Negotiated Rate |
$1,857.49 |
| Max. Negotiated Rate |
$5,970.51 |
| Rate for Payer: Cash Price |
$2,679.92
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,653.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,388.20
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,388.20
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,520.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,653.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,520.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,653.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,653.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,990.17
|
| Rate for Payer: Healthfirst Commercial |
$2,653.56
|
| Rate for Payer: Healthfirst Essential Plan |
$5,970.51
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,520.88
|
| Rate for Payer: Healthfirst QHP |
$2,653.56
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,857.49
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,653.56
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,255.53
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,857.49
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,653.56
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,990.17
|
| Rate for Payer: SOMOS Essential |
$1,990.17
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,653.56
|
|
|
PR CRANIECTOMY W/EXCISION TUMOR/LESION SKULL
|
Professional
|
Both
|
$6,020.67
|
|
|
Service Code
|
HCPCS 61500
|
| Min. Negotiated Rate |
$1,104.02 |
| Max. Negotiated Rate |
$3,548.63 |
| Rate for Payer: Cash Price |
$1,600.43
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,577.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,419.45
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,419.45
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,498.31
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,577.17
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,498.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,577.17
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,577.17
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,182.88
|
| Rate for Payer: Healthfirst Commercial |
$1,577.17
|
| Rate for Payer: Healthfirst Essential Plan |
$3,548.63
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,498.31
|
| Rate for Payer: Healthfirst QHP |
$1,577.17
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,104.02
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,577.17
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,340.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,104.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,577.17
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,182.88
|
| Rate for Payer: SOMOS Essential |
$1,182.88
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,577.17
|
|
|
PR CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR
|
Professional
|
Both
|
$10,598.91
|
|
|
Service Code
|
HCPCS 61510
|
| Min. Negotiated Rate |
$1,940.80 |
| Max. Negotiated Rate |
$6,238.28 |
| Rate for Payer: Cash Price |
$2,798.44
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,772.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,495.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,495.31
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,633.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,772.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,633.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,772.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,772.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,079.43
|
| Rate for Payer: Healthfirst Commercial |
$2,772.57
|
| Rate for Payer: Healthfirst Essential Plan |
$6,238.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,633.94
|
| Rate for Payer: Healthfirst QHP |
$2,772.57
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,940.80
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,772.57
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,356.68
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,940.80
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,772.57
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,079.43
|
| Rate for Payer: SOMOS Essential |
$2,079.43
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,772.57
|
|
|
PR CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ
|
Professional
|
Both
|
$11,042.12
|
|
|
Service Code
|
HCPCS 61580
|
| Min. Negotiated Rate |
$2,050.13 |
| Max. Negotiated Rate |
$6,589.71 |
| Rate for Payer: Cash Price |
$2,962.04
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,928.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,635.88
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,635.88
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,782.32
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,928.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,782.32
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,928.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,928.76
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,196.57
|
| Rate for Payer: Healthfirst Commercial |
$2,928.76
|
| Rate for Payer: Healthfirst Essential Plan |
$6,589.71
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,782.32
|
| Rate for Payer: Healthfirst QHP |
$2,928.76
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,050.13
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,928.76
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,489.45
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,050.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,928.76
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,196.57
|
| Rate for Payer: SOMOS Essential |
$2,196.57
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,928.76
|
|
|
PR CRANIOFACIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ
|
Professional
|
Both
|
$11,743.87
|
|
|
Service Code
|
HCPCS 61581
|
| Min. Negotiated Rate |
$2,171.12 |
| Max. Negotiated Rate |
$6,978.60 |
| Rate for Payer: Cash Price |
$3,161.17
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,101.60
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,791.44
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,791.44
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,946.52
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,101.60
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,946.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,101.60
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,101.60
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,326.20
|
| Rate for Payer: Healthfirst Commercial |
$3,101.60
|
| Rate for Payer: Healthfirst Essential Plan |
$6,978.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,946.52
|
| Rate for Payer: Healthfirst QHP |
$3,101.60
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,171.12
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,101.60
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,636.36
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,171.12
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,101.60
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,326.20
|
| Rate for Payer: SOMOS Essential |
$2,326.20
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,101.60
|
|
|
PR CRANIOPLASTY SKULL DEFECT <5 CM DIAMETER
|
Professional
|
Both
|
$4,804.59
|
|
|
Service Code
|
HCPCS 62140
|
| Min. Negotiated Rate |
$886.75 |
| Max. Negotiated Rate |
$2,850.26 |
| Rate for Payer: Cash Price |
$1,277.46
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,266.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,140.10
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,140.10
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,203.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,266.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,203.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,266.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,266.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$950.09
|
| Rate for Payer: Healthfirst Commercial |
$1,266.78
|
| Rate for Payer: Healthfirst Essential Plan |
$2,850.26
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,203.44
|
| Rate for Payer: Healthfirst QHP |
$1,266.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$886.75
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,266.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,076.76
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$886.75
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,266.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$950.09
|
| Rate for Payer: SOMOS Essential |
$950.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,266.78
|
|
|
PR CRANIOPLASTY SKULL DEFECT >5 CM DIAMETER
|
Professional
|
Both
|
$5,420.63
|
|
|
Service Code
|
HCPCS 62141
|
| Min. Negotiated Rate |
$1,001.77 |
| Max. Negotiated Rate |
$3,219.97 |
| Rate for Payer: Cash Price |
$1,440.59
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,431.10
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,287.99
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,287.99
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,359.55
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,431.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,359.55
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,431.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,431.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,073.33
|
| Rate for Payer: Healthfirst Commercial |
$1,431.10
|
| Rate for Payer: Healthfirst Essential Plan |
$3,219.97
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,359.55
|
| Rate for Payer: Healthfirst QHP |
$1,431.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,001.77
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,431.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,216.43
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,001.77
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,431.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,073.33
|
| Rate for Payer: SOMOS Essential |
$1,073.33
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,431.10
|
|
|
PR CRANIOPLASTY SKULL DEFECT REPARATIVE BRAIN SURG
|
Professional
|
Both
|
$6,813.38
|
|
|
Service Code
|
HCPCS 62145
|
| Min. Negotiated Rate |
$1,230.61 |
| Max. Negotiated Rate |
$3,955.55 |
| Rate for Payer: Cash Price |
$1,807.47
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,758.02
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,582.22
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,582.22
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,670.12
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,758.02
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,670.12
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,758.02
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,758.02
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,318.52
|
| Rate for Payer: Healthfirst Commercial |
$1,758.02
|
| Rate for Payer: Healthfirst Essential Plan |
$3,955.55
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,670.12
|
| Rate for Payer: Healthfirst QHP |
$1,758.02
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,230.61
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,758.02
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,494.32
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,230.61
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,758.02
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,318.52
|
| Rate for Payer: SOMOS Essential |
$1,318.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,758.02
|
|
|
PR CRANIOPLASTY W/AUTOGRAFT <5 CM DIAMETER
|
Professional
|
Both
|
$6,031.87
|
|
|
Service Code
|
HCPCS 62146
|
| Min. Negotiated Rate |
$1,105.66 |
| Max. Negotiated Rate |
$3,553.92 |
| Rate for Payer: Cash Price |
$1,593.57
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,579.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,421.57
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,421.57
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,500.54
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,579.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,500.54
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,579.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,579.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,184.64
|
| Rate for Payer: Healthfirst Commercial |
$1,579.52
|
| Rate for Payer: Healthfirst Essential Plan |
$3,553.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,500.54
|
| Rate for Payer: Healthfirst QHP |
$1,579.52
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,105.66
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,579.52
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,342.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,105.66
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,579.52
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,184.64
|
| Rate for Payer: SOMOS Essential |
$1,184.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,579.52
|
|
|
PR CRANIOPLASTY W/AUTOGRAFT > 5 CM DIAMETER
|
Professional
|
Both
|
$6,721.44
|
|
|
Service Code
|
HCPCS 62147
|
| Min. Negotiated Rate |
$1,251.75 |
| Max. Negotiated Rate |
$4,023.49 |
| Rate for Payer: Cash Price |
$1,782.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,788.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,609.40
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,609.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,698.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,788.22
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,698.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,788.22
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,788.22
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,341.16
|
| Rate for Payer: Healthfirst Commercial |
$1,788.22
|
| Rate for Payer: Healthfirst Essential Plan |
$4,023.49
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,698.81
|
| Rate for Payer: Healthfirst QHP |
$1,788.22
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,251.75
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,788.22
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,519.99
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,251.75
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,788.22
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,341.16
|
| Rate for Payer: SOMOS Essential |
$1,341.16
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,788.22
|
|
|
PR CRANIOT EPILEPTOGENIC FOCUS W/ELECTROCORTCOGRPHY
|
Professional
|
Both
|
$12,454.58
|
|
|
Service Code
|
HCPCS 61536
|
| Min. Negotiated Rate |
$2,271.72 |
| Max. Negotiated Rate |
$7,301.95 |
| Rate for Payer: Cash Price |
$3,276.44
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,245.31
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,920.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,920.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,083.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,245.31
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,083.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,245.31
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,245.31
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,433.98
|
| Rate for Payer: Healthfirst Commercial |
$3,245.31
|
| Rate for Payer: Healthfirst Essential Plan |
$7,301.95
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,083.04
|
| Rate for Payer: Healthfirst QHP |
$3,245.31
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,271.72
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,245.31
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,758.51
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,271.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,245.31
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,433.98
|
| Rate for Payer: SOMOS Essential |
$2,433.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,245.31
|
|
|
PR CRANIOT EPILEPTOGENIC FOC W/O ELECTRCORTICOGRPHY
|
Professional
|
Both
|
$7,966.39
|
|
|
Service Code
|
HCPCS 61534
|
| Min. Negotiated Rate |
$1,458.02 |
| Max. Negotiated Rate |
$4,686.48 |
| Rate for Payer: Cash Price |
$2,102.71
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,082.88
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,874.59
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,874.59
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,978.74
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,082.88
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,978.74
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,082.88
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,082.88
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,562.16
|
| Rate for Payer: Healthfirst Commercial |
$2,082.88
|
| Rate for Payer: Healthfirst Essential Plan |
$4,686.48
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,978.74
|
| Rate for Payer: Healthfirst QHP |
$2,082.88
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,458.02
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,082.88
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,770.45
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,458.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,082.88
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,562.16
|
| Rate for Payer: SOMOS Essential |
$1,562.16
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,082.88
|
|
|
PR CRANIOT HYPOPHYSEC/EXC PITUITARY TUMOR ICRL APPR
|
Professional
|
Both
|
$11,154.50
|
|
|
Service Code
|
HCPCS 61546
|
| Min. Negotiated Rate |
$2,035.13 |
| Max. Negotiated Rate |
$6,541.49 |
| Rate for Payer: Cash Price |
$2,935.88
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,907.33
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,616.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,616.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,761.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,907.33
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,761.96
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,907.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,907.33
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,180.50
|
| Rate for Payer: Healthfirst Commercial |
$2,907.33
|
| Rate for Payer: Healthfirst Essential Plan |
$6,541.49
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,761.96
|
| Rate for Payer: Healthfirst QHP |
$2,907.33
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,035.13
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,907.33
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,471.23
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,035.13
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,907.33
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,180.50
|
| Rate for Payer: SOMOS Essential |
$2,180.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,907.33
|
|
