|
PR CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA
|
Professional
|
Both
|
$13,346.76
|
|
|
Service Code
|
HCPCS 61518
|
| Min. Negotiated Rate |
$2,437.63 |
| Max. Negotiated Rate |
$7,835.24 |
| Rate for Payer: Cash Price |
$3,519.73
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,482.33
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,134.10
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,134.10
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,308.21
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,482.33
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,308.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,482.33
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,482.33
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,611.75
|
| Rate for Payer: Healthfirst Commercial |
$3,482.33
|
| Rate for Payer: Healthfirst Essential Plan |
$7,835.24
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,308.21
|
| Rate for Payer: Healthfirst QHP |
$3,482.33
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,437.63
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,482.33
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,959.98
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,437.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,482.33
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,611.75
|
| Rate for Payer: SOMOS Essential |
$2,611.75
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,482.33
|
|
|
PR CRNEC EXC CEREBELLOPNTIN ANGLE TUM MID/POSTFOSSA
|
Professional
|
Both
|
$14,852.74
|
|
|
Service Code
|
HCPCS 61530
|
| Min. Negotiated Rate |
$2,703.85 |
| Max. Negotiated Rate |
$8,690.94 |
| Rate for Payer: Cash Price |
$3,902.59
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,862.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,476.38
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,476.38
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,669.51
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,862.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,669.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,862.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,862.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,896.98
|
| Rate for Payer: Healthfirst Commercial |
$3,862.64
|
| Rate for Payer: Healthfirst Essential Plan |
$8,690.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,669.51
|
| Rate for Payer: Healthfirst QHP |
$3,862.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,703.85
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,862.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$3,283.24
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,703.85
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,862.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,896.98
|
| Rate for Payer: SOMOS Essential |
$2,896.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,862.64
|
|
|
PR CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA
|
Professional
|
Both
|
$14,230.41
|
|
|
Service Code
|
HCPCS 61519
|
| Min. Negotiated Rate |
$2,592.59 |
| Max. Negotiated Rate |
$8,333.33 |
| Rate for Payer: Cash Price |
$3,732.38
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,703.70
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,333.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,333.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,518.51
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,703.70
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,518.51
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,703.70
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,703.70
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,777.78
|
| Rate for Payer: Healthfirst Commercial |
$3,703.70
|
| Rate for Payer: Healthfirst Essential Plan |
$8,333.33
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,518.51
|
| Rate for Payer: Healthfirst QHP |
$3,703.70
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,592.59
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,703.70
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$3,148.14
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,592.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,703.70
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,777.78
|
| Rate for Payer: SOMOS Essential |
$2,777.78
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,703.70
|
|
|
PR CRNEC INFRATNTORIAL/POST FOSSA EXC BRAIN ABSCESS
|
Professional
|
Both
|
$10,562.65
|
|
|
Service Code
|
HCPCS 61522
|
| Min. Negotiated Rate |
$1,929.59 |
| Max. Negotiated Rate |
$6,202.26 |
| Rate for Payer: Cash Price |
$2,783.41
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,756.56
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,480.90
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,480.90
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,618.73
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,756.56
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,618.73
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,756.56
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,756.56
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,067.42
|
| Rate for Payer: Healthfirst Commercial |
$2,756.56
|
| Rate for Payer: Healthfirst Essential Plan |
$6,202.26
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,618.73
|
| Rate for Payer: Healthfirst QHP |
$2,756.56
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,929.59
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,756.56
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,343.08
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,929.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,756.56
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,067.42
|
| Rate for Payer: SOMOS Essential |
$2,067.42
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,756.56
|
|
|
PR CRNEC INFRATNTOR/POSTFOSSA EXC/FENESTRATION CYST
|
Professional
|
Both
|
$10,067.33
|
|
|
Service Code
|
HCPCS 61524
|
| Min. Negotiated Rate |
$1,838.38 |
| Max. Negotiated Rate |
$5,909.06 |
| Rate for Payer: Cash Price |
$2,652.28
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,626.25
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,363.62
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,363.62
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,494.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,626.25
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,494.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,626.25
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,626.25
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,969.69
|
| Rate for Payer: Healthfirst Commercial |
$2,626.25
|
| Rate for Payer: Healthfirst Essential Plan |
$5,909.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,494.94
|
| Rate for Payer: Healthfirst QHP |
$2,626.25
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,838.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,626.25
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,232.31
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,838.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,626.25
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,969.69
|
| Rate for Payer: SOMOS Essential |
$1,969.69
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,626.25
|
|
|
PR CRNEC SOPL EXPL/DCMPRN CRNL NRV
|
Professional
|
Both
|
$9,732.31
|
|
|
Service Code
|
HCPCS 61458
|
| Min. Negotiated Rate |
$1,779.02 |
| Max. Negotiated Rate |
$5,718.28 |
| Rate for Payer: Cash Price |
$2,556.33
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,541.46
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,287.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,287.31
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,414.39
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,541.46
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,414.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,541.46
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,541.46
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,906.10
|
| Rate for Payer: Healthfirst Commercial |
$2,541.46
|
| Rate for Payer: Healthfirst Essential Plan |
$5,718.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,414.39
|
| Rate for Payer: Healthfirst QHP |
$2,541.46
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,779.02
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,541.46
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,160.24
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,779.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,541.46
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,906.10
|
| Rate for Payer: SOMOS Essential |
$1,906.10
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,541.46
|
|
|
PR CRNEC STPL SCTJ COMPRESSION/DCMPRN GANGLION
|
Professional
|
Both
|
$9,272.38
|
|
|
Service Code
|
HCPCS 61450
|
| Min. Negotiated Rate |
$1,694.10 |
| Max. Negotiated Rate |
$5,445.31 |
| Rate for Payer: Cash Price |
$2,444.19
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,420.14
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,178.13
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,178.13
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,299.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,420.14
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,299.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,420.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,420.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,815.11
|
| Rate for Payer: Healthfirst Commercial |
$2,420.14
|
| Rate for Payer: Healthfirst Essential Plan |
$5,445.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,299.13
|
| Rate for Payer: Healthfirst QHP |
$2,420.14
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,694.10
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,420.14
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,057.12
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,694.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,420.14
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,815.11
|
| Rate for Payer: SOMOS Essential |
$1,815.11
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,420.14
|
|
|
PR CRNEC SUBOCCIPITAL CRV LAM DCMPRN MEDULLA & CORD
|
Professional
|
Both
|
$10,580.85
|
|
|
Service Code
|
HCPCS 61343
|
| Min. Negotiated Rate |
$1,926.64 |
| Max. Negotiated Rate |
$6,192.79 |
| Rate for Payer: Cash Price |
$2,780.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,752.35
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,477.11
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,477.11
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,614.73
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,752.35
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,614.73
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,752.35
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,752.35
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,064.26
|
| Rate for Payer: Healthfirst Commercial |
$2,752.35
|
| Rate for Payer: Healthfirst Essential Plan |
$6,192.79
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,614.73
|
| Rate for Payer: Healthfirst QHP |
$2,752.35
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,926.64
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,752.35
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,339.50
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,926.64
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,752.35
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,064.26
|
| Rate for Payer: SOMOS Essential |
$2,064.26
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,752.35
|
|
|
PR CRNEC TRANSTEMPOR EXC CEREBELLOPONTINE ANGLE TUM
|
Professional
|
Both
|
$15,414.39
|
|
|
Service Code
|
HCPCS 61526
|
| Min. Negotiated Rate |
$2,821.40 |
| Max. Negotiated Rate |
$9,068.78 |
| Rate for Payer: Cash Price |
$4,074.85
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,030.57
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,627.51
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,627.51
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,829.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,030.57
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,829.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,030.57
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,030.57
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3,022.93
|
| Rate for Payer: Healthfirst Commercial |
$4,030.57
|
| Rate for Payer: Healthfirst Essential Plan |
$9,068.78
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,829.04
|
| Rate for Payer: Healthfirst QHP |
$4,030.57
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,821.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$4,030.57
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$3,425.98
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,821.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,030.57
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3,022.93
|
| Rate for Payer: SOMOS Essential |
$3,022.93
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,030.57
|
|
|
PR CRNEC TREPHINE BONE FLAP BRAIN ABSC SUPRATENTOR
|
Professional
|
Both
|
$9,253.34
|
|
|
Service Code
|
HCPCS 61514
|
| Min. Negotiated Rate |
$1,691.74 |
| Max. Negotiated Rate |
$5,437.73 |
| Rate for Payer: Cash Price |
$2,432.88
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,416.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,175.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,175.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,295.93
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,416.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,295.93
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,416.77
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,416.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,812.58
|
| Rate for Payer: Healthfirst Commercial |
$2,416.77
|
| Rate for Payer: Healthfirst Essential Plan |
$5,437.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,295.93
|
| Rate for Payer: Healthfirst QHP |
$2,416.77
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,691.74
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,416.77
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,054.25
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,691.74
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,416.77
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,812.58
|
| Rate for Payer: SOMOS Essential |
$1,812.58
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,416.77
|
|
|
PR CRNEC TREPHINE BONE FLAP FENEST CYST SUPRATENTOR
|
Professional
|
Both
|
$9,020.10
|
|
|
Service Code
|
HCPCS 61516
|
| Min. Negotiated Rate |
$1,647.46 |
| Max. Negotiated Rate |
$5,295.40 |
| Rate for Payer: Cash Price |
$2,384.73
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,353.51
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,118.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,118.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$2,235.83
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,353.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$2,235.83
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,353.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,353.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,765.13
|
| Rate for Payer: Healthfirst Commercial |
$2,353.51
|
| Rate for Payer: Healthfirst Essential Plan |
$5,295.40
|
| Rate for Payer: Healthfirst Medicare Advantage |
$2,235.83
|
| Rate for Payer: Healthfirst QHP |
$2,353.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,647.46
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,353.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,000.48
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,647.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,353.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,765.13
|
| Rate for Payer: SOMOS Essential |
$1,765.13
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,353.51
|
|
|
PR CRNEC TREPHINE BONE FLAP MENINGIOMA SUPRATENTOR
|
Professional
|
Both
|
$12,325.88
|
|
|
Service Code
|
HCPCS 61512
|
| Min. Negotiated Rate |
$2,248.02 |
| Max. Negotiated Rate |
$7,225.78 |
| Rate for Payer: Cash Price |
$3,242.56
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,211.46
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$2,890.31
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$2,890.31
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,050.89
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,211.46
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,050.89
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,211.46
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,211.46
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,408.59
|
| Rate for Payer: Healthfirst Commercial |
$3,211.46
|
| Rate for Payer: Healthfirst Essential Plan |
$7,225.78
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,050.89
|
| Rate for Payer: Healthfirst QHP |
$3,211.46
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,248.02
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,211.46
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$2,729.74
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,248.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,211.46
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,408.59
|
| Rate for Payer: SOMOS Essential |
$2,408.59
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,211.46
|
|
|
PR CRNEC TUM INFRATTL/PFOSSA MIDLINE TUM BASE SKULL
|
Professional
|
Both
|
$15,294.23
|
|
|
Service Code
|
HCPCS 61521
|
| Min. Negotiated Rate |
$2,781.06 |
| Max. Negotiated Rate |
$8,939.11 |
| Rate for Payer: Cash Price |
$4,038.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$3,972.94
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$3,575.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$3,575.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$3,774.29
|
| Rate for Payer: Fidelis Medicare Advantage |
$3,972.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$3,774.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$3,972.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$3,972.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$2,979.70
|
| Rate for Payer: Healthfirst Commercial |
$3,972.94
|
| Rate for Payer: Healthfirst Essential Plan |
$8,939.11
|
| Rate for Payer: Healthfirst Medicare Advantage |
$3,774.29
|
| Rate for Payer: Healthfirst QHP |
$3,972.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$2,781.06
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$3,972.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$3,377.00
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$2,781.06
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$3,972.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$2,979.70
|
| Rate for Payer: SOMOS Essential |
$2,979.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$3,972.94
|
|
|
PR CRNEC TUM INFRATTL/POSTFOSSA CRBLOPNT ANGLE TUM
|
Professional
|
Both
|
$17,762.57
|
|
|
Service Code
|
HCPCS 61520
|
| Min. Negotiated Rate |
$3,233.04 |
| Max. Negotiated Rate |
$10,391.92 |
| Rate for Payer: Cash Price |
$4,650.02
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$4,618.63
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$4,156.77
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$4,156.77
|
| Rate for Payer: Fidelis Essential Plan QHP |
$4,387.70
|
| Rate for Payer: Fidelis Medicare Advantage |
$4,618.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$4,387.70
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$4,618.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$4,618.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$3,463.97
|
| Rate for Payer: Healthfirst Commercial |
$4,618.63
|
| Rate for Payer: Healthfirst Essential Plan |
$10,391.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$4,387.70
|
| Rate for Payer: Healthfirst QHP |
$4,618.63
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$3,233.04
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$4,618.63
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$3,925.84
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$3,233.04
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$4,618.63
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$3,463.97
|
| Rate for Payer: SOMOS Essential |
$3,463.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$4,618.63
|
|
|
PR CRNL RELAXING INC CORRJ INDUCED ASTIGMATISM
|
Professional
|
Both
|
$1,667.23
|
|
|
Service Code
|
HCPCS 65772
|
| Min. Negotiated Rate |
$318.95 |
| Max. Negotiated Rate |
$1,025.19 |
| Rate for Payer: Cash Price |
$461.08
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$455.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$410.08
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$410.08
|
| Rate for Payer: Fidelis Essential Plan QHP |
$432.86
|
| Rate for Payer: Fidelis Medicare Advantage |
$455.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$432.86
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$455.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$455.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$341.73
|
| Rate for Payer: Healthfirst Commercial |
$455.64
|
| Rate for Payer: Healthfirst Essential Plan |
$1,025.19
|
| Rate for Payer: Healthfirst Medicare Advantage |
$432.86
|
| Rate for Payer: Healthfirst QHP |
$455.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$318.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$455.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$387.29
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$318.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$455.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$341.73
|
| Rate for Payer: SOMOS Essential |
$341.73
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$455.64
|
|
|
PR CRNL WEDGE RESCJ CORRJ INDUCED ASTIGMATISM
|
Professional
|
Both
|
$2,376.08
|
|
|
Service Code
|
HCPCS 65775
|
| Min. Negotiated Rate |
$451.38 |
| Max. Negotiated Rate |
$1,450.87 |
| Rate for Payer: Cash Price |
$653.94
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$644.83
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$580.35
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$580.35
|
| Rate for Payer: Fidelis Essential Plan QHP |
$612.59
|
| Rate for Payer: Fidelis Medicare Advantage |
$644.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$612.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$644.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$644.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$483.62
|
| Rate for Payer: Healthfirst Commercial |
$644.83
|
| Rate for Payer: Healthfirst Essential Plan |
$1,450.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$612.59
|
| Rate for Payer: Healthfirst QHP |
$644.83
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$451.38
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$644.83
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$548.11
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$451.38
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$644.83
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$483.62
|
| Rate for Payer: SOMOS Essential |
$483.62
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$644.83
|
|
|
PR CROSS INTRINSIC TRANSFER EACH TENDON
|
Professional
|
Both
|
$2,852.99
|
|
|
Service Code
|
HCPCS 26510
|
| Min. Negotiated Rate |
$527.56 |
| Max. Negotiated Rate |
$1,695.73 |
| Rate for Payer: Cash Price |
$767.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$753.66
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$678.29
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$678.29
|
| Rate for Payer: Fidelis Essential Plan QHP |
$715.98
|
| Rate for Payer: Fidelis Medicare Advantage |
$753.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$715.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$753.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$753.66
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$565.25
|
| Rate for Payer: Healthfirst Commercial |
$753.66
|
| Rate for Payer: Healthfirst Essential Plan |
$1,695.73
|
| Rate for Payer: Healthfirst Medicare Advantage |
$715.98
|
| Rate for Payer: Healthfirst QHP |
$753.66
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$527.56
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$753.66
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$640.61
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$527.56
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$753.66
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$565.25
|
| Rate for Payer: SOMOS Essential |
$565.25
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$753.66
|
|
|
PR CROSS-OVER VEIN GRAFT VENOUS SYSTEM
|
Professional
|
Both
|
$4,408.88
|
|
|
Service Code
|
HCPCS 34520
|
| Min. Negotiated Rate |
$809.72 |
| Max. Negotiated Rate |
$2,602.66 |
| Rate for Payer: Cash Price |
$1,166.48
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,156.74
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,041.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,041.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,098.90
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,156.74
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,098.90
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,156.74
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,156.74
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$867.55
|
| Rate for Payer: Healthfirst Commercial |
$1,156.74
|
| Rate for Payer: Healthfirst Essential Plan |
$2,602.66
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,098.90
|
| Rate for Payer: Healthfirst QHP |
$1,156.74
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$809.72
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,156.74
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$983.23
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$809.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,156.74
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$867.55
|
| Rate for Payer: SOMOS Essential |
$867.55
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,156.74
|
|
|
PR CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF
|
Professional
|
Both
|
$3,525.31
|
|
|
Service Code
|
HCPCS 36825
|
| Min. Negotiated Rate |
$646.23 |
| Max. Negotiated Rate |
$2,077.16 |
| Rate for Payer: Cash Price |
$935.86
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$923.18
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$830.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$830.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$877.02
|
| Rate for Payer: Fidelis Medicare Advantage |
$923.18
|
| Rate for Payer: Fidelis Qualified Health Plan |
$877.02
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$923.18
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$923.18
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$692.38
|
| Rate for Payer: Healthfirst Commercial |
$923.18
|
| Rate for Payer: Healthfirst Essential Plan |
$2,077.16
|
| Rate for Payer: Healthfirst Medicare Advantage |
$877.02
|
| Rate for Payer: Healthfirst QHP |
$923.18
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$646.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$923.18
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$784.70
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$646.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$923.18
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$692.38
|
| Rate for Payer: SOMOS Essential |
$692.38
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$923.18
|
|
|
PR CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF
|
Professional
|
Both
|
$2,957.29
|
|
|
Service Code
|
HCPCS 36830
|
| Min. Negotiated Rate |
$544.41 |
| Max. Negotiated Rate |
$1,749.89 |
| Rate for Payer: Cash Price |
$785.32
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$777.73
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$699.96
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$699.96
|
| Rate for Payer: Fidelis Essential Plan QHP |
$738.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$777.73
|
| Rate for Payer: Fidelis Qualified Health Plan |
$738.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$777.73
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$777.73
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$583.30
|
| Rate for Payer: Healthfirst Commercial |
$777.73
|
| Rate for Payer: Healthfirst Essential Plan |
$1,749.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$738.84
|
| Rate for Payer: Healthfirst QHP |
$777.73
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$544.41
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$777.73
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$661.07
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$544.41
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$777.73
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$583.30
|
| Rate for Payer: SOMOS Essential |
$583.30
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$777.73
|
|
|
PR CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO
|
Professional
|
Both
|
$713.41
|
|
|
Service Code
|
HCPCS 35686
|
| Min. Negotiated Rate |
$130.70 |
| Max. Negotiated Rate |
$420.10 |
| Rate for Payer: Cash Price |
$188.22
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$186.71
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$168.04
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$168.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$177.37
|
| Rate for Payer: Fidelis Medicare Advantage |
$186.71
|
| Rate for Payer: Fidelis Qualified Health Plan |
$177.37
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$186.71
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$186.71
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$140.03
|
| Rate for Payer: Healthfirst Commercial |
$186.71
|
| Rate for Payer: Healthfirst Essential Plan |
$420.10
|
| Rate for Payer: Healthfirst Medicare Advantage |
$177.37
|
| Rate for Payer: Healthfirst QHP |
$186.71
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$130.70
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$186.71
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$158.70
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$130.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$186.71
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$140.03
|
| Rate for Payer: SOMOS Essential |
$140.03
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$186.71
|
|
|
PR CRTJ LES STRTCTC BURR GLOBUS PALLIDUS/THALAMUS
|
Professional
|
Both
|
$6,135.78
|
|
|
Service Code
|
HCPCS 61720
|
| Min. Negotiated Rate |
$1,124.70 |
| Max. Negotiated Rate |
$3,615.12 |
| Rate for Payer: Cash Price |
$1,621.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,606.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,446.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,446.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,526.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,606.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,526.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,606.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,606.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,205.04
|
| Rate for Payer: Healthfirst Commercial |
$1,606.72
|
| Rate for Payer: Healthfirst Essential Plan |
$3,615.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,526.38
|
| Rate for Payer: Healthfirst QHP |
$1,606.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,124.70
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,606.72
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,365.71
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,124.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,606.72
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,205.04
|
| Rate for Payer: SOMOS Essential |
$1,205.04
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,606.72
|
|
|
PR CRTJ LES STRTCTC BURR SUBCORTICAL STRUX OTH/THN
|
Professional
|
Both
|
$7,702.03
|
|
|
Service Code
|
HCPCS 61735
|
| Min. Negotiated Rate |
$1,410.25 |
| Max. Negotiated Rate |
$4,532.94 |
| Rate for Payer: Cash Price |
$2,032.93
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$2,014.64
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,813.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,813.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,913.91
|
| Rate for Payer: Fidelis Medicare Advantage |
$2,014.64
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,913.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$2,014.64
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$2,014.64
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$1,510.98
|
| Rate for Payer: Healthfirst Commercial |
$2,014.64
|
| Rate for Payer: Healthfirst Essential Plan |
$4,532.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,913.91
|
| Rate for Payer: Healthfirst QHP |
$2,014.64
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$1,410.25
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$2,014.64
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,712.44
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$1,410.25
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$2,014.64
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$1,510.98
|
| Rate for Payer: SOMOS Essential |
$1,510.98
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$2,014.64
|
|
|
PR CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX
|
Professional
|
Both
|
$3,417.33
|
|
|
Service Code
|
HCPCS 33025
|
| Min. Negotiated Rate |
$633.23 |
| Max. Negotiated Rate |
$2,035.39 |
| Rate for Payer: Cash Price |
$911.73
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$904.62
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$814.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$814.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$859.39
|
| Rate for Payer: Fidelis Medicare Advantage |
$904.62
|
| Rate for Payer: Fidelis Qualified Health Plan |
$859.39
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$904.62
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$904.62
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$678.47
|
| Rate for Payer: Healthfirst Commercial |
$904.62
|
| Rate for Payer: Healthfirst Essential Plan |
$2,035.39
|
| Rate for Payer: Healthfirst Medicare Advantage |
$859.39
|
| Rate for Payer: Healthfirst QHP |
$904.62
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$633.23
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$904.62
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$768.93
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$633.23
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$904.62
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$678.47
|
| Rate for Payer: SOMOS Essential |
$678.47
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$904.62
|
|
|
PR CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL/OTH W/LAM
|
Professional
|
Both
|
$4,736.55
|
|
|
Service Code
|
HCPCS 63740
|
| Min. Negotiated Rate |
$872.30 |
| Max. Negotiated Rate |
$2,803.84 |
| Rate for Payer: Cash Price |
$1,255.17
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$1,246.15
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$1,121.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$1,121.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$1,183.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$1,246.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$1,183.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$1,246.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$1,246.15
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$934.61
|
| Rate for Payer: Healthfirst Commercial |
$1,246.15
|
| Rate for Payer: Healthfirst Essential Plan |
$2,803.84
|
| Rate for Payer: Healthfirst Medicare Advantage |
$1,183.84
|
| Rate for Payer: Healthfirst QHP |
$1,246.15
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$872.30
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$1,246.15
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$1,059.23
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$872.30
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$1,246.15
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$934.61
|
| Rate for Payer: SOMOS Essential |
$934.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$1,246.15
|
|
