|
PR DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD
|
Professional
|
Both
|
$100.45
|
|
|
Service Code
|
HCPCS 93986 26
|
| Min. Negotiated Rate |
$17.91 |
| Max. Negotiated Rate |
$90.96 |
| Rate for Payer: Amida Care Medicaid |
$90.96
|
| Rate for Payer: Cash Price |
$26.53
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$25.59
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.03
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$23.03
|
| Rate for Payer: Fidelis Essential Plan QHP |
$24.31
|
| Rate for Payer: Fidelis Medicare Advantage |
$25.59
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24.31
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25.59
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$25.59
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19.19
|
| Rate for Payer: Healthfirst Commercial |
$25.59
|
| Rate for Payer: Healthfirst Essential Plan |
$57.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$24.31
|
| Rate for Payer: Healthfirst QHP |
$25.59
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$17.91
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$25.59
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$21.75
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$17.91
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$25.59
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19.19
|
| Rate for Payer: SOMOS Essential |
$19.19
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$25.59
|
|
|
PR DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD
|
Professional
|
Both
|
$557.31
|
|
|
Service Code
|
HCPCS 93986
|
| Min. Negotiated Rate |
$90.96 |
| Max. Negotiated Rate |
$377.91 |
| Rate for Payer: Amida Care Medicaid |
$90.96
|
| Rate for Payer: Cash Price |
$171.83
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$167.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$151.16
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$151.16
|
| Rate for Payer: Fidelis Essential Plan QHP |
$159.56
|
| Rate for Payer: Fidelis Medicare Advantage |
$167.96
|
| Rate for Payer: Fidelis Qualified Health Plan |
$159.56
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$167.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$167.96
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$125.97
|
| Rate for Payer: Healthfirst Commercial |
$167.96
|
| Rate for Payer: Healthfirst Essential Plan |
$377.91
|
| Rate for Payer: Healthfirst Medicare Advantage |
$159.56
|
| Rate for Payer: Healthfirst QHP |
$167.96
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$117.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$167.96
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$142.77
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$117.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$167.96
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$125.97
|
| Rate for Payer: SOMOS Essential |
$125.97
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$167.96
|
|
|
PR DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY
|
Professional
|
Both
|
$156.73
|
|
|
Service Code
|
HCPCS 93880 26
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$145.90 |
| Rate for Payer: Amida Care Medicaid |
$145.90
|
| Rate for Payer: Cash Price |
$42.10
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$41.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$37.22
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$37.22
|
| Rate for Payer: Fidelis Essential Plan QHP |
$39.29
|
| Rate for Payer: Fidelis Medicare Advantage |
$41.36
|
| Rate for Payer: Fidelis Qualified Health Plan |
$39.29
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$41.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$41.36
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$31.02
|
| Rate for Payer: Healthfirst Commercial |
$41.36
|
| Rate for Payer: Healthfirst Essential Plan |
$93.06
|
| Rate for Payer: Healthfirst Medicare Advantage |
$39.29
|
| Rate for Payer: Healthfirst QHP |
$41.36
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$28.95
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$41.36
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$35.16
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$28.95
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$41.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$31.02
|
| Rate for Payer: SOMOS Essential |
$31.02
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$41.36
|
|
|
PR DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY
|
Professional
|
Both
|
$666.44
|
|
|
Service Code
|
HCPCS 93880 TC
|
| Min. Negotiated Rate |
$122.75 |
| Max. Negotiated Rate |
$394.56 |
| Rate for Payer: Amida Care Medicaid |
$145.90
|
| Rate for Payer: Cash Price |
$180.66
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$175.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$157.82
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$157.82
|
| Rate for Payer: Fidelis Essential Plan QHP |
$166.59
|
| Rate for Payer: Fidelis Medicare Advantage |
$175.36
|
| Rate for Payer: Fidelis Qualified Health Plan |
$166.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$175.36
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$175.36
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$131.52
|
| Rate for Payer: Healthfirst Commercial |
$175.36
|
| Rate for Payer: Healthfirst Essential Plan |
$394.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$166.59
|
| Rate for Payer: Healthfirst QHP |
$175.36
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$122.75
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$175.36
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$149.06
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$122.75
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$175.36
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$131.52
|
| Rate for Payer: SOMOS Essential |
$131.52
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$175.36
|
|
|
PR DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY
|
Professional
|
Both
|
$823.17
|
|
|
Service Code
|
HCPCS 93880
|
| Min. Negotiated Rate |
$145.90 |
| Max. Negotiated Rate |
$487.62 |
| Rate for Payer: Amida Care Medicaid |
$145.90
|
| Rate for Payer: Cash Price |
$222.76
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$216.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$195.05
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$195.05
|
| Rate for Payer: Fidelis Essential Plan QHP |
$205.88
|
| Rate for Payer: Fidelis Medicare Advantage |
$216.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$205.88
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$216.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$216.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$162.54
|
| Rate for Payer: Healthfirst Commercial |
$216.72
|
| Rate for Payer: Healthfirst Essential Plan |
$487.62
|
| Rate for Payer: Healthfirst Medicare Advantage |
$205.88
|
| Rate for Payer: Healthfirst QHP |
$216.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$151.70
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$216.72
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$184.21
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$151.70
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$216.72
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$162.54
|
| Rate for Payer: SOMOS Essential |
$162.54
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$216.72
|
|
|
PR DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY
|
Professional
|
Both
|
$537.18
|
|
|
Service Code
|
HCPCS 93882
|
| Min. Negotiated Rate |
$99.59 |
| Max. Negotiated Rate |
$320.11 |
| Rate for Payer: Amida Care Medicaid |
$136.31
|
| Rate for Payer: Cash Price |
$146.61
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$142.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$128.04
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$128.04
|
| Rate for Payer: Fidelis Essential Plan QHP |
$135.16
|
| Rate for Payer: Fidelis Medicare Advantage |
$142.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$135.16
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$142.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$142.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$106.70
|
| Rate for Payer: Healthfirst Commercial |
$142.27
|
| Rate for Payer: Healthfirst Essential Plan |
$320.11
|
| Rate for Payer: Healthfirst Medicare Advantage |
$135.16
|
| Rate for Payer: Healthfirst QHP |
$142.27
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$99.59
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$142.27
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$120.93
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$99.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$142.27
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$106.70
|
| Rate for Payer: SOMOS Essential |
$106.70
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$142.27
|
|
|
PR DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY
|
Professional
|
Both
|
$101.89
|
|
|
Service Code
|
HCPCS 93882 26
|
| Min. Negotiated Rate |
$18.02 |
| Max. Negotiated Rate |
$136.31 |
| Rate for Payer: Amida Care Medicaid |
$136.31
|
| Rate for Payer: Cash Price |
$26.69
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$25.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$23.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$24.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$25.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$25.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19.31
|
| Rate for Payer: Healthfirst Commercial |
$25.75
|
| Rate for Payer: Healthfirst Essential Plan |
$57.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$24.46
|
| Rate for Payer: Healthfirst QHP |
$25.75
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$18.02
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$25.75
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$21.89
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$18.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$25.75
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19.31
|
| Rate for Payer: SOMOS Essential |
$19.31
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$25.75
|
|
|
PR DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY
|
Professional
|
Both
|
$435.30
|
|
|
Service Code
|
HCPCS 93882 TC
|
| Min. Negotiated Rate |
$81.56 |
| Max. Negotiated Rate |
$262.17 |
| Rate for Payer: Amida Care Medicaid |
$136.31
|
| Rate for Payer: Cash Price |
$119.92
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$116.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$104.87
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$104.87
|
| Rate for Payer: Fidelis Essential Plan QHP |
$110.69
|
| Rate for Payer: Fidelis Medicare Advantage |
$116.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$110.69
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$116.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$116.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$87.39
|
| Rate for Payer: Healthfirst Commercial |
$116.52
|
| Rate for Payer: Healthfirst Essential Plan |
$262.17
|
| Rate for Payer: Healthfirst Medicare Advantage |
$110.69
|
| Rate for Payer: Healthfirst QHP |
$116.52
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$81.56
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$116.52
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$99.04
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$81.56
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$116.52
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$87.39
|
| Rate for Payer: SOMOS Essential |
$87.39
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$116.52
|
|
|
PR DUPLEX SCAN HEMODIALYSIS ACCESS
|
Professional
|
Both
|
$557.17
|
|
|
Service Code
|
HCPCS 93990
|
| Min. Negotiated Rate |
$87.75 |
| Max. Negotiated Rate |
$379.31 |
| Rate for Payer: Amida Care Medicaid |
$87.75
|
| Rate for Payer: Cash Price |
$173.63
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$168.58
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$151.72
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$151.72
|
| Rate for Payer: Fidelis Essential Plan QHP |
$160.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$168.58
|
| Rate for Payer: Fidelis Qualified Health Plan |
$160.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$168.58
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$168.58
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$126.44
|
| Rate for Payer: Healthfirst Commercial |
$168.58
|
| Rate for Payer: Healthfirst Essential Plan |
$379.31
|
| Rate for Payer: Healthfirst Medicare Advantage |
$160.15
|
| Rate for Payer: Healthfirst QHP |
$168.58
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$118.01
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$168.58
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$143.29
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$118.01
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$168.58
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$126.44
|
| Rate for Payer: SOMOS Essential |
$126.44
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$168.58
|
|
|
PR DUPLEX SCAN HEMODIALYSIS ACCESS
|
Professional
|
Both
|
$456.86
|
|
|
Service Code
|
HCPCS 93990 TC
|
| Min. Negotiated Rate |
$87.75 |
| Max. Negotiated Rate |
$321.21 |
| Rate for Payer: Amida Care Medicaid |
$87.75
|
| Rate for Payer: Cash Price |
$146.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$142.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$128.48
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$128.48
|
| Rate for Payer: Fidelis Essential Plan QHP |
$135.62
|
| Rate for Payer: Fidelis Medicare Advantage |
$142.76
|
| Rate for Payer: Fidelis Qualified Health Plan |
$135.62
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$142.76
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$142.76
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$107.07
|
| Rate for Payer: Healthfirst Commercial |
$142.76
|
| Rate for Payer: Healthfirst Essential Plan |
$321.21
|
| Rate for Payer: Healthfirst Medicare Advantage |
$135.62
|
| Rate for Payer: Healthfirst QHP |
$142.76
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$99.93
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$142.76
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$121.35
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$99.93
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$142.76
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$107.07
|
| Rate for Payer: SOMOS Essential |
$107.07
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$142.76
|
|
|
PR DUPLEX SCAN HEMODIALYSIS ACCESS
|
Professional
|
Both
|
$100.31
|
|
|
Service Code
|
HCPCS 93990 26
|
| Min. Negotiated Rate |
$18.07 |
| Max. Negotiated Rate |
$87.75 |
| Rate for Payer: Amida Care Medicaid |
$87.75
|
| Rate for Payer: Cash Price |
$26.76
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$25.82
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.24
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$23.24
|
| Rate for Payer: Fidelis Essential Plan QHP |
$24.53
|
| Rate for Payer: Fidelis Medicare Advantage |
$25.82
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24.53
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25.82
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$25.82
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19.36
|
| Rate for Payer: Healthfirst Commercial |
$25.82
|
| Rate for Payer: Healthfirst Essential Plan |
$58.09
|
| Rate for Payer: Healthfirst Medicare Advantage |
$24.53
|
| Rate for Payer: Healthfirst QHP |
$25.82
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$18.07
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$25.82
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$21.95
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$18.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$25.82
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19.36
|
| Rate for Payer: SOMOS Essential |
$19.36
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$25.82
|
|
|
PR DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE
|
Professional
|
Both
|
$159.18
|
|
|
Service Code
|
HCPCS 93978 26
|
| Min. Negotiated Rate |
$30.46 |
| Max. Negotiated Rate |
$148.16 |
| Rate for Payer: Amida Care Medicaid |
$148.16
|
| Rate for Payer: Cash Price |
$42.80
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$43.52
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$39.17
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$39.17
|
| Rate for Payer: Fidelis Essential Plan QHP |
$41.34
|
| Rate for Payer: Fidelis Medicare Advantage |
$43.52
|
| Rate for Payer: Fidelis Qualified Health Plan |
$41.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$43.52
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$43.52
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$32.64
|
| Rate for Payer: Healthfirst Commercial |
$43.52
|
| Rate for Payer: Healthfirst Essential Plan |
$97.92
|
| Rate for Payer: Healthfirst Medicare Advantage |
$41.34
|
| Rate for Payer: Healthfirst QHP |
$43.52
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$30.46
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$43.52
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$36.99
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$30.46
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$43.52
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$32.64
|
| Rate for Payer: SOMOS Essential |
$32.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$43.52
|
|
|
PR DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE
|
Professional
|
Both
|
$621.88
|
|
|
Service Code
|
HCPCS 93978 TC
|
| Min. Negotiated Rate |
$115.69 |
| Max. Negotiated Rate |
$371.86 |
| Rate for Payer: Amida Care Medicaid |
$148.16
|
| Rate for Payer: Cash Price |
$169.27
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$165.27
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$148.74
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$148.74
|
| Rate for Payer: Fidelis Essential Plan QHP |
$157.01
|
| Rate for Payer: Fidelis Medicare Advantage |
$165.27
|
| Rate for Payer: Fidelis Qualified Health Plan |
$157.01
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$165.27
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$165.27
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$123.95
|
| Rate for Payer: Healthfirst Commercial |
$165.27
|
| Rate for Payer: Healthfirst Essential Plan |
$371.86
|
| Rate for Payer: Healthfirst Medicare Advantage |
$157.01
|
| Rate for Payer: Healthfirst QHP |
$165.27
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$115.69
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$165.27
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$140.48
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$115.69
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$165.27
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$123.95
|
| Rate for Payer: SOMOS Essential |
$123.95
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$165.27
|
|
|
PR DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE
|
Professional
|
Both
|
$781.06
|
|
|
Service Code
|
HCPCS 93978
|
| Min. Negotiated Rate |
$146.15 |
| Max. Negotiated Rate |
$469.78 |
| Rate for Payer: Amida Care Medicaid |
$148.16
|
| Rate for Payer: Cash Price |
$212.07
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$208.79
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$187.91
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$187.91
|
| Rate for Payer: Fidelis Essential Plan QHP |
$198.35
|
| Rate for Payer: Fidelis Medicare Advantage |
$208.79
|
| Rate for Payer: Fidelis Qualified Health Plan |
$198.35
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$208.79
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$208.79
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$156.59
|
| Rate for Payer: Healthfirst Commercial |
$208.79
|
| Rate for Payer: Healthfirst Essential Plan |
$469.78
|
| Rate for Payer: Healthfirst Medicare Advantage |
$198.35
|
| Rate for Payer: Healthfirst QHP |
$208.79
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$146.15
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$208.79
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$177.47
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$146.15
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$208.79
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$156.59
|
| Rate for Payer: SOMOS Essential |
$156.59
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$208.79
|
|
|
PR DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD
|
Professional
|
Both
|
$93.70
|
|
|
Service Code
|
HCPCS 93979 26
|
| Min. Negotiated Rate |
$18.02 |
| Max. Negotiated Rate |
$94.79 |
| Rate for Payer: Amida Care Medicaid |
$94.79
|
| Rate for Payer: Cash Price |
$26.69
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$25.75
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$23.18
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$23.18
|
| Rate for Payer: Fidelis Essential Plan QHP |
$24.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$25.75
|
| Rate for Payer: Fidelis Qualified Health Plan |
$24.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$25.75
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$25.75
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$19.31
|
| Rate for Payer: Healthfirst Commercial |
$25.75
|
| Rate for Payer: Healthfirst Essential Plan |
$57.94
|
| Rate for Payer: Healthfirst Medicare Advantage |
$24.46
|
| Rate for Payer: Healthfirst QHP |
$25.75
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$18.02
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$25.75
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$21.89
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$18.02
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$25.75
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$19.31
|
| Rate for Payer: SOMOS Essential |
$19.31
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$25.75
|
|
|
PR DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD
|
Professional
|
Both
|
$503.09
|
|
|
Service Code
|
HCPCS 93979
|
| Min. Negotiated Rate |
$94.42 |
| Max. Negotiated Rate |
$303.50 |
| Rate for Payer: Amida Care Medicaid |
$94.79
|
| Rate for Payer: Cash Price |
$138.75
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$134.89
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$121.40
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$121.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$128.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$134.89
|
| Rate for Payer: Fidelis Qualified Health Plan |
$128.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$134.89
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$134.89
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$101.17
|
| Rate for Payer: Healthfirst Commercial |
$134.89
|
| Rate for Payer: Healthfirst Essential Plan |
$303.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$128.15
|
| Rate for Payer: Healthfirst QHP |
$134.89
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$94.42
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$134.89
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$114.66
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$94.42
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$134.89
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$101.17
|
| Rate for Payer: SOMOS Essential |
$101.17
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$134.89
|
|
|
PR DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD
|
Professional
|
Both
|
$409.40
|
|
|
Service Code
|
HCPCS 93979 TC
|
| Min. Negotiated Rate |
$76.40 |
| Max. Negotiated Rate |
$245.56 |
| Rate for Payer: Amida Care Medicaid |
$94.79
|
| Rate for Payer: Cash Price |
$112.06
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$109.14
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$98.23
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$98.23
|
| Rate for Payer: Fidelis Essential Plan QHP |
$103.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$109.14
|
| Rate for Payer: Fidelis Qualified Health Plan |
$103.68
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$109.14
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$109.14
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$81.86
|
| Rate for Payer: Healthfirst Commercial |
$109.14
|
| Rate for Payer: Healthfirst Essential Plan |
$245.56
|
| Rate for Payer: Healthfirst Medicare Advantage |
$103.68
|
| Rate for Payer: Healthfirst QHP |
$109.14
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$76.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$109.14
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$92.77
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$76.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$109.14
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$81.86
|
| Rate for Payer: SOMOS Essential |
$81.86
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$109.14
|
|
|
PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM
|
Professional
|
Both
|
$1,143.84
|
|
|
Service Code
|
HCPCS 93975
|
| Min. Negotiated Rate |
$192.23 |
| Max. Negotiated Rate |
$676.91 |
| Rate for Payer: Amida Care Medicaid |
$192.23
|
| Rate for Payer: Cash Price |
$309.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$300.85
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$270.76
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$270.76
|
| Rate for Payer: Fidelis Essential Plan QHP |
$285.81
|
| Rate for Payer: Fidelis Medicare Advantage |
$300.85
|
| Rate for Payer: Fidelis Qualified Health Plan |
$285.81
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$300.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$300.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$225.64
|
| Rate for Payer: Healthfirst Commercial |
$300.85
|
| Rate for Payer: Healthfirst Essential Plan |
$676.91
|
| Rate for Payer: Healthfirst Medicare Advantage |
$285.81
|
| Rate for Payer: Healthfirst QHP |
$300.85
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$210.59
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$300.85
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$255.72
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$210.59
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$300.85
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$225.64
|
| Rate for Payer: SOMOS Essential |
$225.64
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$300.85
|
|
|
PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM
|
Professional
|
Both
|
$227.29
|
|
|
Service Code
|
HCPCS 93975 26
|
| Min. Negotiated Rate |
$41.76 |
| Max. Negotiated Rate |
$192.23 |
| Rate for Payer: Amida Care Medicaid |
$192.23
|
| Rate for Payer: Cash Price |
$60.62
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$59.66
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$53.69
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$53.69
|
| Rate for Payer: Fidelis Essential Plan QHP |
$56.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$59.66
|
| Rate for Payer: Fidelis Qualified Health Plan |
$56.68
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$59.66
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$59.66
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$44.74
|
| Rate for Payer: Healthfirst Commercial |
$59.66
|
| Rate for Payer: Healthfirst Essential Plan |
$134.24
|
| Rate for Payer: Healthfirst Medicare Advantage |
$56.68
|
| Rate for Payer: Healthfirst QHP |
$59.66
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$41.76
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$59.66
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$50.71
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$41.76
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$59.66
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$44.74
|
| Rate for Payer: SOMOS Essential |
$44.74
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$59.66
|
|
|
PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM
|
Professional
|
Both
|
$916.58
|
|
|
Service Code
|
HCPCS 93975 TC
|
| Min. Negotiated Rate |
$168.83 |
| Max. Negotiated Rate |
$542.68 |
| Rate for Payer: Amida Care Medicaid |
$192.23
|
| Rate for Payer: Cash Price |
$248.87
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$241.19
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$217.07
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$217.07
|
| Rate for Payer: Fidelis Essential Plan QHP |
$229.13
|
| Rate for Payer: Fidelis Medicare Advantage |
$241.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$229.13
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$241.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$241.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$180.89
|
| Rate for Payer: Healthfirst Commercial |
$241.19
|
| Rate for Payer: Healthfirst Essential Plan |
$542.68
|
| Rate for Payer: Healthfirst Medicare Advantage |
$229.13
|
| Rate for Payer: Healthfirst QHP |
$241.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$168.83
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$241.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$205.01
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$168.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$241.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$180.89
|
| Rate for Payer: SOMOS Essential |
$180.89
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$241.19
|
|
|
PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT
|
Professional
|
Both
|
$608.23
|
|
|
Service Code
|
HCPCS 93976
|
| Min. Negotiated Rate |
$127.20 |
| Max. Negotiated Rate |
$408.87 |
| Rate for Payer: Amida Care Medicaid |
$168.37
|
| Rate for Payer: Cash Price |
$185.13
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$181.72
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$163.55
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$163.55
|
| Rate for Payer: Fidelis Essential Plan QHP |
$172.63
|
| Rate for Payer: Fidelis Medicare Advantage |
$181.72
|
| Rate for Payer: Fidelis Qualified Health Plan |
$172.63
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$181.72
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$181.72
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$136.29
|
| Rate for Payer: Healthfirst Commercial |
$181.72
|
| Rate for Payer: Healthfirst Essential Plan |
$408.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$172.63
|
| Rate for Payer: Healthfirst QHP |
$181.72
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$127.20
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$181.72
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$154.46
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$127.20
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$181.72
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$136.29
|
| Rate for Payer: SOMOS Essential |
$136.29
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$181.72
|
|
|
PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT
|
Professional
|
Both
|
$151.38
|
|
|
Service Code
|
HCPCS 93976 26
|
| Min. Negotiated Rate |
$28.63 |
| Max. Negotiated Rate |
$168.37 |
| Rate for Payer: Amida Care Medicaid |
$168.37
|
| Rate for Payer: Cash Price |
$41.64
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$40.90
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36.81
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$36.81
|
| Rate for Payer: Fidelis Essential Plan QHP |
$38.85
|
| Rate for Payer: Fidelis Medicare Advantage |
$40.90
|
| Rate for Payer: Fidelis Qualified Health Plan |
$38.85
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40.90
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$40.90
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30.68
|
| Rate for Payer: Healthfirst Commercial |
$40.90
|
| Rate for Payer: Healthfirst Essential Plan |
$92.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$38.85
|
| Rate for Payer: Healthfirst QHP |
$40.90
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$28.63
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$40.90
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$34.77
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$28.63
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$40.90
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$30.68
|
| Rate for Payer: SOMOS Essential |
$30.68
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$40.90
|
|
|
PR DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT
|
Professional
|
Both
|
$456.86
|
|
|
Service Code
|
HCPCS 93976 TC
|
| Min. Negotiated Rate |
$98.57 |
| Max. Negotiated Rate |
$316.82 |
| Rate for Payer: Amida Care Medicaid |
$168.37
|
| Rate for Payer: Cash Price |
$143.49
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$140.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$126.73
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$126.73
|
| Rate for Payer: Fidelis Essential Plan QHP |
$133.77
|
| Rate for Payer: Fidelis Medicare Advantage |
$140.81
|
| Rate for Payer: Fidelis Qualified Health Plan |
$133.77
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$140.81
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$140.81
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$105.61
|
| Rate for Payer: Healthfirst Commercial |
$140.81
|
| Rate for Payer: Healthfirst Essential Plan |
$316.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$133.77
|
| Rate for Payer: Healthfirst QHP |
$140.81
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$98.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$140.81
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$119.69
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$98.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$140.81
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$105.61
|
| Rate for Payer: SOMOS Essential |
$105.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$140.81
|
|
|
PR DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL
|
Professional
|
Both
|
$248.54
|
|
|
Service Code
|
HCPCS 93980 TC
|
| Min. Negotiated Rate |
$47.44 |
| Max. Negotiated Rate |
$152.48 |
| Rate for Payer: Amida Care Medicaid |
$142.28
|
| Rate for Payer: Cash Price |
$69.00
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$67.77
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$60.99
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$60.99
|
| Rate for Payer: Fidelis Essential Plan QHP |
$64.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$67.77
|
| Rate for Payer: Fidelis Qualified Health Plan |
$64.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$67.77
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$67.77
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$50.83
|
| Rate for Payer: Healthfirst Commercial |
$67.77
|
| Rate for Payer: Healthfirst Essential Plan |
$152.48
|
| Rate for Payer: Healthfirst Medicare Advantage |
$64.38
|
| Rate for Payer: Healthfirst QHP |
$67.77
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$47.44
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$67.77
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$57.60
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$47.44
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$67.77
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$50.83
|
| Rate for Payer: SOMOS Essential |
$50.83
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$67.77
|
|
|
PR DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL
|
Professional
|
Both
|
$232.19
|
|
|
Service Code
|
HCPCS 93980 26
|
| Min. Negotiated Rate |
$44.65 |
| Max. Negotiated Rate |
$143.50 |
| Rate for Payer: Amida Care Medicaid |
$142.28
|
| Rate for Payer: Cash Price |
$64.79
|
| Rate for Payer: Centers Plan For Healthy Living Dual Advantage/Medicare Advantage/Medicare Advantage Plus |
$63.78
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$57.40
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$57.40
|
| Rate for Payer: Fidelis Essential Plan QHP |
$60.59
|
| Rate for Payer: Fidelis Medicare Advantage |
$63.78
|
| Rate for Payer: Fidelis Qualified Health Plan |
$60.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$63.78
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$63.78
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$47.84
|
| Rate for Payer: Healthfirst Commercial |
$63.78
|
| Rate for Payer: Healthfirst Essential Plan |
$143.50
|
| Rate for Payer: Healthfirst Medicare Advantage |
$60.59
|
| Rate for Payer: Healthfirst QHP |
$63.78
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$44.65
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$63.78
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$54.21
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$44.65
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$63.78
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$47.84
|
| Rate for Payer: SOMOS Essential |
$47.84
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$63.78
|
|
